Provider Demographics
NPI:1588003735
Name:MCCORMICK, JULIE ELLEN (CRNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELLEN
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:FRANKLIN
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3007 MEMORIAL PKWY SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5393
Mailing Address - Country:US
Mailing Address - Phone:256-799-2500
Mailing Address - Fax:
Practice Address - Street 1:3007 MEMORIAL PKWY SW
Practice Address - Street 2:SUITE B
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5393
Practice Address - Country:US
Practice Address - Phone:256-799-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-098195363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health