Healthcare Provider Details

I. General information

NPI: 1821952821
Provider Name (Legal Business Name): RONALD STEVEN MCCOY APRN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 266
BRUNO WV
25611-0266
US

IV. Provider business mailing address

PO BOX 266
BRUNO WV
25611-0266
US

V. Phone/Fax

Practice location:
  • Phone: 304-687-1036
  • Fax:
Mailing address:
  • Phone: 304-687-1036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number103001
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: