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General NPI Number Information
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NPI Number | 1598342172
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Entity Type | Individual
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Provider Name | ASHLEY MCCORMICK CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2021
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 4435 RONALD REAGAN BLVD
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City | JOHNSTOWN
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State | CO
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Zip | 80534-6566
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Country | US
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Telephone | 970-619-8139
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 RALEIGH ST UNIT 519
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City | DENVER
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State | CO
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Zip | 80204-2181
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Country | US
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Telephone | 720-635-3281
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APN.0995975-NP
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License Number State | CO
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