MS. MARY ELLEN MCCORMICK CRNP NPI 1013960236

NPI Information

  • NPI: 1013960236
  • Provider Name: MS. MARY ELLEN MCCORMICK, CRNP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 150 MUNDY ST
    MAC IV BUILDING
    WILKES BARRE, PA
    ZIP 18702
  • Phone: (570) 824-0930

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NPI Details

MS. Mary Ellen Mccormick, CRNP is a nurse practitioner in Wilkes Barre, PA. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. MS. Mary Ellen Mccormick, CRNP NPI is 1013960236. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

150 MUNDY ST
MAC IV BUILDING
WILKES BARRE, PA
ZIP 18702-830
Phone: (570) 824-0930
Fax: (570) 824-7755

The enumeration date for this NPI number is 5/18/2006 and was last updated on 6/18/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerVP003894CPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S64281MEDICARE UPINPENNSYLVANIA
2019287J67MEDICARE PINPENNSYLVANIA
350076332OTHERPENNSYLVANIACAPITAL BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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