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Shuntay Mccormick

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

163 Augustine Dr, Hattiesburg, MS 39402-7836

PECOS Enrollment

Based on the most recent information from CMS, provider Shuntay Mccormick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1467931642
Provider Type
Individual
Full Name
Mccormick, Shuntay
Gender
Female

Sole Proprietor
No
Enumeration Date
8/9/2018
Last Updated
8/9/2018

Contact Information

Practice Location

163 Augustine Dr, Hattiesburg, MS 39402-7836

(601) 467-6281

Unlisted Fax

Mailing Location

163 Augustine Dr, Hattiesburg, MS 39402-7836

(601) 467-6281

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 902849 Mississippi

Shuntay Mccormick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Wallace, Susan R

Med Options Llc.

Ford, Julie

Monroe, Teresa S

Cochran, Shelley S

Hunt, April

Perkins, Kayla Leigh Ashley

Pou, Lindsi

Heidelburg, Tavithia

Dawson, Cynthia