PENNY S CORNELIUS (PA) – Physician Assistant, NPI 1184609331

Physician Assistant

PENNY S CORNELIUS (PA) is a healthcare provider. based in Green bay, Wisconsin. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 696-023 (WI). The NPI Number for PENNY S CORNELIUS (PA) is 1184609331

Main info

Female

34 Years Of Experience

Name

PENNY S CORNELIUS (PA)

NPI

1184609331

Phone

(920) 496-1631

Address

2618 FORESTVILLE DR

Enumeration Date

9 December 2005

Last Update Date

11 November 2008

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4144232700

Graduation Year

1992 (34 years ago)

PAC ID

9830085661

Group Practice PAC ID

7719996792

Professional Enrollment ID

I20040226001070

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for PENNY S CORNELIUS (PA)

2618, Forestville Drive, MacArthur Heights, Green Bay, Brown County, Wisconsin, 54304, United States
GREEN BAY, WI 543041358
Phone: (920) 496-1631
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54304)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7719996792View full group profile

Name	Specialty	State
STACEY L GLOVER	-	WI
JOHN DAVID WISE (PA)	Physician Assistant	IL
MISS TAMARA J VAN LANNEN (NP)	-	WI
MRS. MARINA KOVACEVIC HORSCHAK (FNP)	-	IL
KRISTEN N RUSSELL (APNP)	-	WI
WENDY L HALM (APNP)	-	WI
KAITLIN M ENGLE (NP)	-	WI
MICHELLE WERNER (FNP)	-	WI
MICHELLE M MINDHAM (APNP)	-	WI
MRS. DIANE J HABERMAN (PA-C)	-	WI

Reviews

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Frequently asked questions

What is PENNY S CORNELIUS (PA)'s NPI number?

PENNY S CORNELIUS (PA)'s NPI is 1184609331 — the number used across U.S. healthcare to identify this provider.

Is PENNY S CORNELIUS (PA) shown as active in public data?

Registry records indicate PENNY S CORNELIUS (PA) maintains an active NPI.

What clinical focus is listed for PENNY S CORNELIUS (PA)?

At a glance, PENNY S CORNELIUS (PA) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.

Where in Wisconsin is PENNY S CORNELIUS (PA) registered?

Use Green Bay, Wisconsin as the headline location for PENNY S CORNELIUS (PA) here.

Does inactive status remove historical data?

Historical rows can remain visible after status changes — read the dates carefully.

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