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General NPI Number Information
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NPI Number | 1639991623
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Entity Type | Organization
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Legal Business Name | MCCOY MEDICAL LLC
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 700 W CENTRAL AVE STE 206
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City | EL DORADO
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State | KS
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Zip | 67042-2186
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Country | US
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Telephone | 316-452-1568
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Fax |
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Provider Business Mailing Address
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Address Line | 700 W CENTRAL AVE STE 206
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City | EL DORADO
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State | KS
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Zip | 67042-2186
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Country | US
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Telephone | 316-452-1568
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | KAYLA NICOLE MCCOY
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Credential | APRN
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Telephone | 620-583-7451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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