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General NPI Number Information
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NPI Number | 1326910670
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Entity Type | Individual
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Provider Name | ANGEL MCCORMICK APRN
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 601 DOE RUN DR STE 5
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City | MOUNT STERLING
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State | KY
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Zip | 40353-9097
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Country | US
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Telephone | 859-361-6420
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 NILES DR
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City | LEXINGTON
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State | KY
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Zip | 40517-3026
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Country | US
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Telephone | 859-361-6420
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4046648
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License Number State | KY
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