Healthcare Provider Details

I. General information

NPI: 1750569893
Provider Name (Legal Business Name): NANCY RUDD-MCCOY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW 11TH ST SUITE E-19
HERMISTON OR
97838-8602
US

IV. Provider business mailing address

600 NW 11TH ST SUITE E-19
HERMISTON OR
97838-8602
US

V. Phone/Fax

Practice location:
  • Phone: 541-289-0395
  • Fax: 541-289-0405
Mailing address:
  • Phone: 541-289-0395
  • Fax: 541-289-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCY ANN RUDD-MCCOY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 541-289-0395