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NPI Code Detail

MEDICARE: MRS. MELEA MCCORMICK APRN

MEDICARE: MRS. MELEA MCCORMICK APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner213043OK

General Provider Information

NPI Number : 1225722804
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELEA MCCORMICK APRN
Provider Business Mailing Address
First Line : 6108 S 31ST ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-7555
Country : US
Telephone Number : 479-242-9355
Fax Number :
Provider Business Practice Location Address
First Line : 6108 S 31ST ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-7555
Country : US
Telephone Number : 479-242-9355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2023
Last Update Date : 03/21/2026

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