Provider Demographics
NPI:1598342172
Name:MCCORMICK, ASHLEY (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 RALEIGH ST UNIT 519
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2181
Mailing Address - Country:US
Mailing Address - Phone:720-635-3281
Mailing Address - Fax:
Practice Address - Street 1:4435 RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-6566
Practice Address - Country:US
Practice Address - Phone:970-619-8139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995975-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics