Individual
CHARLES DAVID MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1200 CENTRAL AVE STE 4, ASHLAND, KY 41101-7575
(606) 324-1483
(606) 329-2612
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012698
KY
363LF0000X
Family Nurse Practitioner
APRN.CNP.0030172
OH
363LF0000X
Family Nurse Practitioner
APRN79987NO
WV
Other
Enumeration date
09/28/2018
Last updated
10/20/2022
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