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NPI Code Detail

MEDICARE: MS. GWEN E MCCORMICK CNM

MEDICARE: MS. GWEN E MCCORMICK CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1176B00000XMidwife172229CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578516068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GWEN E MCCORMICK CNM
Provider Business Mailing Address
First Line : 340 PRINTERS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80910-3190
Country : US
Telephone Number : 719-630-6440
Fax Number : 719-228-6609
Provider Business Practice Location Address
First Line : 350 PRINTERS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80910-3190
Country : US
Telephone Number : 719-632-5700
Fax Number : 719-228-6644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 05/07/2008

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Directions to “ MS. GWEN E MCCORMICK CNM” Practice Location

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