Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP019946 | PA |
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP019946 | PA |
NPI | 1043873011 |
---|---|
Provider Name | Cara Mccormick |
First Address | Allentown, PA 18106-8944 |
Second Address | Reading, PA 19602-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2019 |
Last Update Date | 16/04/2019 |