Individual
MRS. MARTHA LYNNELL MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1501 KALAMAZOO DR STE B, GRIFFIN, GA 30224-3998
(678) 603-1321
(678) 603-2750
Mailing address
1501 KALAMAZOO DR STE B, GRIFFIN, GA 30224-3998
(678) 603-1321
(678) 603-2750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN123048
GA
Other
Enumeration date
06/09/2005
Last updated
07/13/2020
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