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General NPI Number Information
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NPI Number | 1992157440
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Entity Type | Individual
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Provider Name | ANNA WILKINS MCCORMICK NP
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Gender | Female
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Dates
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Enumeration Date | 07/08/2016
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 5306 SIX FORKS RD STE 217
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City | RALEIGH
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State | NC
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Zip | 27609-4468
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Country | US
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Telephone | 919-739-4287
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Fax | 919-890-9237
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Provider Business Mailing Address
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Address Line | PO BOX 603949
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City | CHARLOTTE
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State | NC
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Zip | 28260-3949
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Country | US
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Telephone |
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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 | 5008710
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5008710
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 5008710
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License Number State | NC
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