Individual
MR. BRIAN GERALD MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
4600 COLLEGE BLVD STE 103, OVERLAND PARK, KS 66211-1606
(913) 215-5008
(913) 297-1202
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-7117
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
14-133095-111
KS
163WE0003X
Emergency Registered Nurse
2013031549
MO
363LF0000X
Family Nurse Practitioner
Primary
2019015044
MO
363LF0000X
Family Nurse Practitioner
78736
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013031549
RN LICENSE NUMBER
MO
01
—
K02-98-0483
STATE DRIVER'S LICENSE
KS
Enumeration date
08/25/2018
Last updated
11/18/2025
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