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General NPI Number Information
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NPI Number | 1033076781
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Entity Type | Individual
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Provider Name | STEVIE MCCORMICK
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1 AVENUE C
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City | MADISON
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State | WV
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Zip | 25130-1100
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Country | US
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Telephone | 304-242-8404
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Fax |
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Provider Business Mailing Address
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Address Line | 478 BEAVER POND CREEK ROAD
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City | BIM
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State | WV
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Zip | 25021
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Country | US
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Telephone | 304-242-8404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | WV
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