Individual
MABEL MCCORRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
22890 VIRGIL GOODE HWY, BOONES MILL, VA 24065
(540) 344-5511
(540) 344-3174
Mailing address
213 S JEFFERSON ST STE 625, ROANOKE, VA 24011-1713
(540) 224-5516
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024166899
VA
363LF0000X
Family Nurse Practitioner
0024166899
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639278690
—
VA
05
—
PENDING
—
VA
Enumeration date
09/22/2006
Last updated
07/21/2022
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