Provider Demographics
NPI:1184254179
Name:MCCOY, TAYLOR ALESE (FNP)
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:ALESE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:ALESE
Other - Last Name:HOLBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-952-2111
Mailing Address - Fax:423-282-1657
Practice Address - Street 1:6419 BRISTOL HWY
Practice Address - Street 2:
Practice Address - City:PINEY FLATS
Practice Address - State:TN
Practice Address - Zip Code:37686-5208
Practice Address - Country:US
Practice Address - Phone:423-302-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-19
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207547163WC0200X
TN27145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine