Mccormick, Michael Kelly

Mccormick, Michael Kelly is an individual health care provider with primary practice located at 701 Dellwood St S , Cambridge MN 55008-1920. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Mccormick, Michael Kelly can be contacted via phone (763) 689-7700.

Contact Information

Primary practice address
701 Dellwood St S Cambridge MN 55008-1920
Phone: (763) 689-7700
Fax: (763) 689-7941
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R102090-8 Minnesota

Profile Details

NPI number 1972684892
LBN Legal business name Mccormick, Michael Kelly
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1972684892 NPPES
Minnesota MEDICAID 767043500

Popular Providers