Healthcare Provider Details

I. General information

NPI: 1427396571
Provider Name (Legal Business Name): MARGARET ROSE ADAMS MCCORMACK CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET ROSE MCCORMACK CNM, WHNP

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 PRINCE ST APT 2
BERKELEY CA
94705-2635
US

IV. Provider business mailing address

2725 PRINCE ST APT 2
BERKELEY CA
94705-2635
US

V. Phone/Fax

Practice location:
  • Phone: 509-771-0369
  • Fax:
Mailing address:
  • Phone: 509-771-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201350003NP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP60307622
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number22939
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP60308035
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number201350002NP
License Number StateOR
# 6
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: