Provider Demographics
NPI:1871572438
Name:MCCORMICK, EILEEN M (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:M
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:WHNP-BC
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Other - Credentials:
Mailing Address - Street 1:15515 N REEMS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9549
Mailing Address - Country:US
Mailing Address - Phone:623-544-1000
Mailing Address - Fax:623-544-1025
Practice Address - Street 1:15515 N REEMS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9549
Practice Address - Country:US
Practice Address - Phone:623-544-1000
Practice Address - Fax:623-544-1025
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN051676363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z125931Medicare PIN