MEDICARE: MARGARET M MCCOY PHD APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2036204405	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S42099	OTHER	UT	MEDICARE ADVANTAGE PLAN
2	500012492	OTHER	UT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	942938348MC4	OTHER	UT	EDUCATORS MUTUAL
4	107001405101	OTHER	UT	INTRMTN. HEALTH CARE
5	2621242	OTHER	UT	DESERET MUTUAL

General Provider Information

NPI Number	:	1407839236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET M MCCOY PHD APRN

Provider Business Mailing Address
First Line	:	1907 VINTAGE WOODS COURT
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117
Country	:	US
Telephone Number	:	801-998-8012
Fax Number	:	801-998-8012

Provider Business Practice Location Address
First Line	:	1907 VINTAGE WOODS COURT
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117
Country	:	US
Telephone Number	:	801-998-8012
Fax Number	:	801-998-8012

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	08/08/2012

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