Individual
MS. GRETA ANITA MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
151 FREESTATE BLVD STE A, SHREVEPORT, LA 71107-6549
(318) 226-5990
Mailing address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
227483
LA
Other
Enumeration date
04/29/2008
Last updated
06/28/2023
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