Heidi J McCormick, RN
Individual provider Active NPI Registered Nurse · Nowthen, MN
NPI 1083976633 · NPPES record last updated Jun 11, 2012
Key facts
- NPI
- 1083976633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R-180492-0 (MN)
- Practice address
- 19175 Burns Pkwy
Nowthen, MN 55303-9525 - Phone
- (763) 257-7771
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-180492-0 | MN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R-180492-0 | MN | Yes |
Addresses
Primary practice location
19175 Burns Pkwy
Nowthen, MN 55303-9525
Mailing address
19175 Burns Pkwy
Nowthen, MN 55303-9525
Phone (763) 257-7771
Other providers in Nowthen, MN
All providers in Nowthen, MN · Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.