Individual
KRISTEN MICHELLE MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
616 CHAFFEE ST, TALLADEGA, AL 35160-2809
(256) 362-4197
Mailing address
100 PERRY HILL RD STE 575, MONTGOMERY, AL 36109-3630
(334) 546-5978
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-141418
AL
363LF0000X
Family Nurse Practitioner
Primary
1-141418
AL
Other
Enumeration date
04/22/2022
Last updated
01/22/2024
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