Provider Demographics
NPI:1780568410
Name:MCCORMICK, JASMINE (RN)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:CORRIVEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4231 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-5028
Mailing Address - Country:US
Mailing Address - Phone:321-289-0076
Mailing Address - Fax:
Practice Address - Street 1:2930 IMMOKALEE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1408
Practice Address - Country:US
Practice Address - Phone:321-289-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9673709163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse