Asha K Kornegay, ARNP
Individual provider Active NPI Pediatric Nurse Practitioner · Indiantown, FL
NPI 1740382829 · NPPES record last updated Mar 19, 2019
Key facts
- NPI
- 1740382829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 2147212 (FL)
- Practice address
- 15858 SW Warfield Blvd.
Indiantown, FL 34956-0648 - Phone
- (772) 597-3596
- Fax
- (844) 542-4898
- NPI assigned
- Sep 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2147212 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Community Health Centers, Inc. | Past | Accepting new patients |
Interoperability endpoints
- asha.kornegay.1@14865.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2147212 | FL | Yes |
Addresses
Primary practice location
15858 SW Warfield Blvd.
Indiantown, FL 34956-0648
Mailing address
5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 306528600 | Medicaid | FL |
Other providers in Indiantown, FL
- Corina Istanich
- Lakesha Jackson
- Angelina Jimenez
- Maria Luisa Jimenez
- Alexis King
- Alan M Kruger
- KV Medical Alliance
- Gillian Lawrick
- Legacy Behavioral Health Center
- Legacy Behavioral Health Center Inc
All providers in Indiantown, FL · Pediatric Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.