Provider Demographics
NPI:1427238781
Name:MCCOIN, DONNA WARD (NP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:WARD
Last Name:MCCOIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-4609
Mailing Address - Country:US
Mailing Address - Phone:423-870-0983
Mailing Address - Fax:
Practice Address - Street 1:420 W BELL AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3404
Practice Address - Country:US
Practice Address - Phone:423-265-2271
Practice Address - Fax:423-785-3494
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012815363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health