Provider Demographics
NPI:1831443688
Name:MCCORMICK, MARCY (CRNP)
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 BANK ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2603
Mailing Address - Country:US
Mailing Address - Phone:724-544-9190
Mailing Address - Fax:
Practice Address - Street 1:336 COLLEGE AVE
Practice Address - Street 2:STE 102
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2231
Practice Address - Country:US
Practice Address - Phone:724-544-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012444363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health