Provider Demographics
NPI:1467808873
Name:MCCORMICK, JULIE ANN (MSN, CNM, ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:MSN, CNM, ARNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CNM, ARNP
Mailing Address - Street 1:105 W 8TH AVE STE 6020
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2319
Mailing Address - Country:US
Mailing Address - Phone:509-209-8016
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 6020
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2319
Practice Address - Country:US
Practice Address - Phone:509-879-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANP60657328367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2063861Medicaid