Provider Demographics
NPI:1972375749
Name:MCCOY, ASIA MARIE (APRN-FNP)
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:MARIE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 N ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2831
Mailing Address - Country:US
Mailing Address - Phone:402-939-6966
Mailing Address - Fax:531-466-3342
Practice Address - Street 1:2226 N ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2831
Practice Address - Country:US
Practice Address - Phone:402-939-6966
Practice Address - Fax:531-466-3342
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily