Provider Demographics
NPI:1366884827
Name:MCCOY, PATRICIA ANN
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W ELY ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-1781
Mailing Address - Country:US
Mailing Address - Phone:330-614-2751
Mailing Address - Fax:
Practice Address - Street 1:250 W ELY ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-1781
Practice Address - Country:US
Practice Address - Phone:330-614-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36556030191E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH365560350191EOtherCERTIFIED NURSE AIDEREGISTRY NUMBER