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General NPI Number Information
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NPI Number | 1265724777
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Entity Type | Individual
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Provider Name | MAUREEN MCCOY NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 5000 CEDAR PLAZA PKWY SUITE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63128-4345
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Country | US
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Telephone | 314-616-5537
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Fax |
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Provider Business Mailing Address
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Address Line | 722 LOUGHBOROUGH AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63111-2732
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Country | US
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Telephone | 314-616-5537
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Fax | 636-333-4522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2011003422
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License Number State | MO
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