Individual
PAMELA MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
(617) 421-6084
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
155852
MA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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