Individual
MRS. AMBER JEAN MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6114 GATE TREE LANE, FORT WAYNE, IN 46835-2746
(260) 486-2880
Mailing address
6114 GATE TREE LANE, FORT WAYNE, IN 46835-2746
(260) 486-2880
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.304895
OH
363LF0000X
Family Nurse Practitioner
Primary
28142320A
IN
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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