Individual
URSULA SUE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28114646
IN
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
70000019A
IN
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
70000019A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374550
ANTHEM
—
05
—
200110210A
—
IN
Enumeration date
12/01/2005
Last updated
04/03/2024
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