JENNIFER MCCORMACK (NPI# 1073170668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073170668 |
| Entity Type | Individual |
| Full Name | JENNIFER MCCORMACK |
| Credential | APRN |
| Practice Address |
2715 Bolton Boone Dr Ste B Desoto TX 75115-2079 |
| Practice Telephone | 9727808009 |
| Practice Fax Number | 9727806115 |
| Mailing Telephone | 9727808009 |
| Mailing Fax Number | 9727806115 |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP141637 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528513660 | Jennifer Mccormack | Early Intervention Provider Agency | 275 Perimeter St, Holbrook, NY 11741-3821 | 2016-08-18 |
| 1205015476 | Jennifer A Mccormack | Occupational Therapist | 43 Ledgewood Dr, Milford, NH 03055 | 2007-10-24 |
| 1710134671 | Jennifer Mccormack | Dentist | 319 W Landis Ave, Vineland, NJ 08360-8101 | 2008-08-22 |
| 1083889414 | Jennifer M.h. Mccormack | Pediatrics | 8450 Seasons Parkway, Healthpartners Woodbury Clinic Ms 32900a, Woodbury, MN 55125-4402 | 2008-04-27 |
| Street Address |
2715 BOLTON BOONE DR STE B |
| City | DESOTO |
| State | TX |
| Zip Code | 75115-2079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1407453384 | Heather Mcdowell | Massage Therapist | 100 Bob White St # 3, Desoto, TX 75115 | 2020-10-05 |
| 1295201580 | Daniel Max & Marcandrea, LLC | Optometrist | 1309 E. Pleasant Run Rd, Desoto, TX 75115 | 2018-10-15 |
| 1316432180 | Texas Home Health Group of De Soto, LLC | Home Health | 911 York Drive, Suite 203, De Soto, TX 75115 | 2018-06-25 |
| 1033606694 | Dental Health Associates of Texas, PC | Dentist | 1001 N Beckley, Desoto, TX 75115 | 2018-04-19 |
| 1023516093 | Joseph Chinaecherem Anya | Pharmacist | 805 Raintree Ln, Desoto, TX 75115 | 2018-01-25 |
| 1396253837 | Medical Care Innovation, P.C. | Clinic/Center | 2019 N Interstate 35 E, Desoto, TX 75115 | 2018-01-18 |
| 1124534888 | Herlonda Dotson | Counselor | 620 Candelila Drive, Desoto, TX 75115 | 2017-12-18 |
| 1053839548 | Floristene Johnson | Nutritionist | 1353 Armstrong Drive, Desoto, TX 75115 | 2017-09-05 |
| 1699290577 | Dlb Pharmacy LLC | Pharmacy | 1801 N Hampton, Suite 340, Desoto, TX 75115 | 2017-08-11 |
| Find all providers in zip 75115 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178267 | Zakiya Muse | Nurse Practitioner | 932 E Danbury Dr, Desoto, TX 75115-5562 | 2020-06-08 |
| 1982237228 | Best Quality Healthcare | Nurse Practitioner | 1321 Mountain Laurel Ln, Desoto, TX 75115-5341 | 2020-02-14 |
| 1942830708 | Angelei Guzman Mercado | Nurse Practitioner | 2505 Bolton Boone Dr Ste 101, Desoto, TX 75115-2097 | 2020-01-21 |
| 1649828534 | Shoshauna Franklin | Nurse Practitioner | 1117 Beeblossom Dr, Desoto, TX 75115-6648 | 2019-09-03 |
| 1093285504 | Kikelomo Omolola Dawotola | Nurse Practitioner | 1008 Angie Ln, Desoto, TX 75115-3870 | 2018-11-27 |
| 1295222024 | Tisa D Collins-douglas | Nurse Practitioner | 617 Inglewood Ct, Desoto, TX 75115-6321 | 2018-04-17 |
| 1578062089 | Valarie Denise Crawford | Nurse Practitioner | 1701 N Hampton Rd Ste B, Desoto, TX 75115-2387 | 2018-02-09 |
| 1699220707 | Katherine Anne Williams Johnson | Nurse Practitioner | 947 Scotland Dr, Suite #107, Desoto, TX 75115-2090 | 2016-08-18 |
| 1457703779 | Lavea Anmarie Landrum | Nurse Practitioner | 1121 Surrey Dr, Desoto, TX 75115-8121 | 2016-07-11 |
| 1730536335 | Dianna Harris | Nurse Practitioner | 1208 Primrose Ct, Desoto, TX 75115-2776 | 2016-05-24 |
| Find all providers in DESOTO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.