Healthcare Provider Details

I. General information

NPI: 1326420316
Provider Name (Legal Business Name): NICOLE MCCORMICK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 S DOWNING ST STE 380
DENVER CO
80210-5850
US

IV. Provider business mailing address

2535 S DOWNING ST STE 380
DENVER CO
80210-5850
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-5797
  • Fax: 303-778-5205
Mailing address:
  • Phone: 303-778-5797
  • Fax: 303-778-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0991809-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: