Provider Demographics
NPI:1972075646
Name:MCCORMICK, CARMEN (NP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 DICKERSON PIKE STE 310
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2523
Mailing Address - Country:US
Mailing Address - Phone:615-645-3013
Mailing Address - Fax:615-621-3158
Practice Address - Street 1:3443 DICKERSON PIKE STE 310
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2523
Practice Address - Country:US
Practice Address - Phone:615-645-3013
Practice Address - Fax:615-621-3158
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000024965363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health