Individual
LISA MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 MEDICAL PL, SEYMOUR, IN 47274-2640
(812) 522-1613
Mailing address
1130 ERNEST DR, SEYMOUR, IN 47274-3102
(812) 525-9613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28166970A
IN
363LF0000X
Family Nurse Practitioner
Primary
28166970A
IN
Other
Enumeration date
10/23/2015
Last updated
11/06/2015
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