MEDICARE: MEGAN ELIZABETH MCCOY-VIALPANDO FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CNP01267	NM

General Provider Information

NPI Number	:	1093956179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ELIZABETH MCCOY-VIALPANDO FNP-BC

Provider Business Mailing Address
First Line	:	7704 2ND ST NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-6708
Country	:	US
Telephone Number	:	505-890-1458
Fax Number	:

Provider Business Practice Location Address
First Line	:	7704 2ND ST NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-6708
Country	:	US
Telephone Number	:	505-890-1458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	04/26/2011

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