MEDICARE: TARYN MCCOY

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	163W00000X	Registered Nurse	258779	TN
2	363LF0000X	Family Nurse Practitioner	33372	TN

General Provider Information

NPI Number	:	1720739196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARYN MCCOY

Provider Business Mailing Address
First Line	:	2608 8TH AVE S APT 405
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3160
Country	:	US
Telephone Number	:	815-791-8575
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 MURFREESBORO PIKE # A
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-2003
Country	:	US
Telephone Number	:	615-747-6035
Fax Number	:

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	10/13/2023

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Directions to “ TARYN MCCOY ” Practice Location

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