Individual
DR. SHELLEY J. MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 W 42ND STREET, SUITE 2800, SCOTTSBLUFF, NE 69361-4660
(308) 630-7977
(308) 630-1028
Mailing address
PO BOX 1498, SCOTTSBLUFF, NE 69363-1498
(308) 630-7977
(308) 630-1028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21064
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24554
MIDLANDS CHOICE PROVIDER
NE
01
—
35049
BC/BS PROVIDER NUMBER
NE
05
—
39200784100
—
NE
Enumeration date
10/25/2006
Last updated
11/19/2014
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