Provider Demographics
NPI:1487033049
Name:MCCORMICK, PAULA
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4232
Mailing Address - Country:US
Mailing Address - Phone:803-774-0447
Mailing Address - Fax:803-774-3004
Practice Address - Street 1:447 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4232
Practice Address - Country:US
Practice Address - Phone:803-774-0447
Practice Address - Fax:803-774-3004
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374J00000XNursing Service Related ProvidersDoula
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide