Provider Demographics
NPI:1356454490
Name:MCCOY, PATRICIA K (APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:K
Last Name:MCCOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6765
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206-0765
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:305 NW ENGLEWOOD CT
Practice Address - Street 2:SUITE 300
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-4072
Practice Address - Country:US
Practice Address - Phone:816-453-7473
Practice Address - Fax:816-453-1940
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102672363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health