Provider Demographics
NPI:1770310609
Name:MCCORMICK, KAREN MARIE (FDN-P)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:FDN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 THEODORA LN APT 320
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-8287
Mailing Address - Country:US
Mailing Address - Phone:904-534-8305
Mailing Address - Fax:
Practice Address - Street 1:1729 THEODORA LN APT 320
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-8287
Practice Address - Country:US
Practice Address - Phone:904-534-8305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach