Individual
SANDRA LEE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 GRIFFIN RD, SUITE A, PORTSMOUTH, NH 03801-7113
(603) 436-7897
(603) 433-1985
Mailing address
3 GREAT HILL WAY, ELIOT, ME 03903-1618
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
02004921
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30346941
—
NH
05
—
3083632
—
NH
01
—
P01011563
RAILROAD MEDICARE
NH
Enumeration date
12/15/2005
Last updated
07/02/2013
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