Provider Demographics
NPI:1235455916
Name:MCCOY, VALARIE DIANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:VALARIE
Middle Name:DIANE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SUNNY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1738
Mailing Address - Country:US
Mailing Address - Phone:937-329-0181
Mailing Address - Fax:
Practice Address - Street 1:65 SUNNY LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1738
Practice Address - Country:US
Practice Address - Phone:937-329-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 096466164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse