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NPI Code Detail

MEDICARE: MIKEA MCCOY PMHNP

MEDICARE: MIKEA MCCOY PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerSP026813PA

General Provider Information

NPI Number : 1922710136
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKEA MCCOY PMHNP
Provider Business Mailing Address
First Line : 2395 LANCASTER PIKE
Second Line :
City : READING
State : PA
Zip : 19607-2375
Country : US
Telephone Number : 610-375-7454
Fax Number :
Provider Business Practice Location Address
First Line : 2395 LANCASTER PIKE
Second Line :
City : READING
State : PA
Zip : 19607-2375
Country : US
Telephone Number : 610-375-7454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2022
Last Update Date : 06/03/2025

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