Most Relevant Information
Provider Data
| NPI Number: | 1003455361 |
| Provider Name: | ASHLEY ANDERSON MCCORMACK |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 26970 |
Most Important Dates
| Enumeration Date: | 01/03/2020 |
| Last Updated: | 04/20/2023 |
Provider Practice Location
1670 W MAIN ST STE 140
LEBANON
TN
370871345
Practice Location Phone/Fax
| Phone: | 6159948201 |
| Fax: |
Provider Mailing Location
3810 CENTRAL PIKE
HERMITAGE
TN
370763494
Provider Mailing Phone/Fax
| Phone: | 9319679393 |
| Fax: |