Provider Demographics
NPI:1578388906
Name:KORNEGAY, NICOLE LEIGH-ALLEN (REFLEXOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LEIGH-ALLEN
Last Name:KORNEGAY
Suffix:
Gender:F
Credentials:REFLEXOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-9294
Mailing Address - Country:US
Mailing Address - Phone:919-738-4223
Mailing Address - Fax:
Practice Address - Street 1:112 E NASH ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2548
Practice Address - Country:US
Practice Address - Phone:919-738-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist