Provider Demographics
NPI:1740141431
Name:MCCOY, RANNELLE JAZZLENE (RN)
Entity type:Individual
Prefix:MS
First Name:RANNELLE
Middle Name:JAZZLENE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8162 VILLA DE LA PLAYA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1669
Mailing Address - Country:US
Mailing Address - Phone:401-612-4466
Mailing Address - Fax:
Practice Address - Street 1:8162 VILLA DE LA PLAYA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1669
Practice Address - Country:US
Practice Address - Phone:401-612-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-21
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV837541163W00000X, 163WX0200X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
No163WX0200XNursing Service ProvidersRegistered NurseOncology