Individual
MEGAN MARIE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA - S
Contact information
Practice address
2736 E JULIET DR, MERIDIAN, ID 83642-5091
(208) 895-8290
Mailing address
2736 E JULIET DR, MERIDIAN, ID 83642-5091
(208) 895-8290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
06/27/2022
Last updated
11/22/2023
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