Provider Demographics
NPI:1750262408
Name:CORNERSTONE PEDIATRICS, PLLC
Entity type:Organization
Organization Name:CORNERSTONE PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CPNP-PC
Authorized Official - Phone:918-519-7315
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:KIEFER
Mailing Address - State:OK
Mailing Address - Zip Code:74041-0103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4458 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:KIEFER
Practice Address - State:OK
Practice Address - Zip Code:74041-3029
Practice Address - Country:US
Practice Address - Phone:918-519-7315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty