Provider Demographics
NPI:1740287648
Name:MCCORMICK, RAMONA MICHELLE (CRNA)
Entity type:Individual
Prefix:MISS
First Name:RAMONA
Middle Name:MICHELLE
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 KATHRYN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-1324
Mailing Address - Country:US
Mailing Address - Phone:610-372-6614
Mailing Address - Fax:
Practice Address - Street 1:6TH AND SPRUCE STS.
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19612-6052
Practice Address - Country:US
Practice Address - Phone:610-988-8589
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN260938L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020209Medicare ID - Type Unspecified