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Individual

MS. ELLEN MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-BC, MS, RD

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DX2995
MD
163W00000X
Registered Nurse
661054-1
NY
363LA2200X
Adult Health Nurse Practitioner
306800
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
RN1034391
DC

Other

Enumeration date
10/06/2009
Last updated
08/06/2014
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