Provider Demographics
NPI:1487625356
Name:MCCOY, HOLLIE ELIZABETH (RDH)
Entity type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:ELIZABETH
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 BROCKIE ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8021
Mailing Address - Country:US
Mailing Address - Phone:757-479-5496
Mailing Address - Fax:
Practice Address - Street 1:BRANCH HEALTH CLINIC,NAVAL AMPHIBIOUS BASE,LITTLE CREEK
Practice Address - Street 2:1035 NIDER BLVD, SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23521-2731
Practice Address - Country:US
Practice Address - Phone:757-314-7435
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6987124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist