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Individual

EMILY L MCCORMAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2352C HIGHWAY 15 N, PONTOTOC, MS 38863-8998
(662) 597-7977
(662) 597-7977
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903001
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
903001
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00018203
MS
Enumeration date
10/31/2018
Last updated
06/13/2025
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