Provider Demographics
NPI:1477291078
Name:MCCORMICK, CHELSEY LEONA (WHNP)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:LEONA
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 MEDICAL PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7554
Mailing Address - Country:US
Mailing Address - Phone:512-392-0033
Mailing Address - Fax:
Practice Address - Street 1:2003 MEDICAL PKWY STE B
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7554
Practice Address - Country:US
Practice Address - Phone:512-392-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057060363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty