Healthcare Provider Details

I. General information

NPI: 1588003735
Provider Name (Legal Business Name): JULIE ELLEN MCCORMICK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE FRANKLIN BEARD CRNP

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 MEMORIAL PKWY SW SUITE B
HUNTSVILLE AL
35801-5393
US

IV. Provider business mailing address

3007 MEMORIAL PKWY SW SUITE B
HUNTSVILLE AL
35801-5393
US

V. Phone/Fax

Practice location:
  • Phone: 256-799-2500
  • Fax:
Mailing address:
  • Phone: 256-799-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-098195
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-098195
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: