Basic Information
| Provider Information | |||||||||
| NPI: | 1326527425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORNETT | ||||||||
| FirstName: | BILLIE JO | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 W LINCOLN AVE STE 411 | ||||||||
| Address2: | |||||||||
| City: | WEST ALLIS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532272409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143286000 | ||||||||
| FaxNumber: | 4143288536 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 W LINCOLN AVE STE 411 | ||||||||
| Address2: | |||||||||
| City: | WEST ALLIS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532272409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143286000 | ||||||||
| FaxNumber: | 4143288536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2018 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 148955 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.