Individual
EMILY L MCCORMAC
Active
Sole proprietor
Yes
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
2352C HIGHWAY 15 N, PONTOTOC, MS 38863-8998
(662) 205-0305
(662) 200-9053
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
05
—
005521216
—
MS
Enumeration date
10/31/2018
Last updated
08/12/2026
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