Mccormack, Jennifer L

Mccormack, Jennifer L is an sole proprietor health care provider with primary practice located at 1000 Eddy St , Providence RI 02905-4739. She recently has only one registered license in Agencies / Case Management, which is considered as her primary health care specialty. Mccormack, Jennifer L can be contacted via phone (401) 533-9165.

Contact Information

Primary practice address
1000 Eddy St Providence RI 02905-4739
Phone: (401) 533-9165
Fax: (401) 533-9105
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1972252104
LBN Legal business name Mccormack, Jennifer L
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2022
Last updated Mar 23rd, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972252104 NPPES
Rhode Island Other 0614 NHPRI
Rhode Island MEDICAID ES01788 NHPRI
Rhode Island Other SB870 NHPRI

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