Individual
ANGELA SHEPHERD MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
9125 CROSS PARK DR STE 200, KNOXVILLE, TN 37923
(865) 632-5900
(865) 374-2129
Mailing address
9125 CROSS PARK DR STE 200, KNOXVILLE, TN 37923-4563
(865) 632-5900
(865) 374-2129
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02758
NC
363A00000X
Physician Assistant
Primary
3766
TN
363A00000X
Physician Assistant
PA9110624
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285932152
—
NC
05
—
5913782
—
NC
05
—
Q046394
—
TN
Enumeration date
03/02/2011
Last updated
08/31/2020
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