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Individual
MARY MCCOY
Active
Individual
MARY MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1212355
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F1212355
TMB NP
TX
Enumeration date
11/02/2016
Last updated
11/02/2016
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