Individual
SHANNON GREEN MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CFCP
Contact information
Practice address
4612 S. CLAIBORNE AVE., NEW ORLEANS, LA 70125
(504) 496-0212
Mailing address
4612 S CLAIBORNE AVE, NEW ORLEANS, LA 70125-5010
(504) 496-0212
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
71607
LA
363LW0102X
Women's Health Nurse Practitioner
Primary
204160
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295281806
CENTERS FOR MEDICARE AND MEDICAID SERVICES IDENTITY & ACCESS (I&A) SYSTEM
—
Enumeration date
09/01/2016
Last updated
09/26/2024
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