Healthcare Provider Details

I. General information

NPI: 1710645601
Provider Name (Legal Business Name): OLIVIA CATHERINE MCCOY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA CATHERINE BRINEGAR

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 N 18TH ST STE 7
CENTERVILLE IA
52544-1161
US

IV. Provider business mailing address

717 N 18TH ST STE 7
CENTERVILLE IA
52544-1161
US

V. Phone/Fax

Practice location:
  • Phone: 641-436-2232
  • Fax: 641-222-1671
Mailing address:
  • Phone: 641-895-9635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA166756
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG185968
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: