Individual
MRS. DOMONEEK MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 JOHNSON FERRY RD NE, ATLANTA, GA 30328-3004
(678) 542-8810
Mailing address
100 JOHNSON FERRY RD NE, ATLANTA, GA 30328-3004
(678) 542-8810
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN250569
GA
163W00000X
Registered Nurse
RN9476648
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN250569
GA
390200000X
Student in an Organized Health Care Education/Training Program
122031
FL
Other
Enumeration date
02/22/2019
Last updated
12/20/2021
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