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Individual

MRS. HOLLY A MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
249 MAIN ST, CADIZ, KY 42211-9154
(270) 206-7114
Mailing address
PO BOX 1724, CADIZ, KY 42211
(270) 522-0898
(270) 522-5636

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004005
KY
363LF0000X
Family Nurse Practitioner
4005P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78010816
KY
Enumeration date
05/16/2006
Last updated
03/31/2020
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