Elizabeth E McCormack, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3151122 Issued in FL

Practice address

14 W Jordan St
Suite C
Pensacola, FL 32501-1736

Phone

(850) 434-0077

Fax

(850) 434-0220

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378598400000",
    "number": "1629120217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST",
            "address_2": "SUITE C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011736",
            "telephone_number": "850-434-0077",
            "fax_number": "850-434-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST",
            "address_2": "SUITE C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011736",
            "telephone_number": "850-434-0077",
            "fax_number": "850-434-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3151122",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "3151122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y107Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306069100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Margret McCollum, RBT
• Dylan Blake McCombs
• Frank McCool, RPH
• Renee S McCorcle, NP
• Cassandra Diane McCorkle, CTRS
• Tracey Claire McCormack
• Tameka Renee McCormick
• McCormicks Compassionate Care LLC
• Jasmine Aleta McCorvey, LMHC
• Shane McCoskey

• Family Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.