Jan McCormick, EDD
Individual provider Active NPI Contractor · Springdale, AR
NPI 1669665113 · NPPES record last updated Aug 18, 2007
Key facts
- NPI
- 1669665113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 4704 Dean PL
Springdale, AR 72764-2536 - Phone
- (479) 927-3007
- NPI assigned
- Aug 18, 2007
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
4704 Dean PL
Springdale, AR 72764-2536
Mailing address
4704 Dean PL
Springdale, AR 72764-2536
Phone (479) 927-3007
Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2007. 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.