Provider Demographics
NPI:1407839236
Name:MCCOY, MARGARET M (PHD APRN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PHD APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 VINTAGE WOODS COURT
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117
Mailing Address - Country:US
Mailing Address - Phone:801-998-8012
Mailing Address - Fax:801-998-8012
Practice Address - Street 1:1907 VINTAGE WOODS COURT
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117
Practice Address - Country:US
Practice Address - Phone:801-998-8012
Practice Address - Fax:801-998-8012
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2036204405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTS42099OtherMEDICARE ADVANTAGE PLAN
UT500012492OtherRAILROAD MEDICARE
UT942938348MC4OtherEDUCATORS MUTUAL
UT107001405101OtherINTRMTN. HEALTH CARE
UT2621242OtherDESERET MUTUAL
UT004662093Medicare PIN
UT000065381Medicare PIN
UT004662131Medicare PIN
UT005739002Medicare PIN
UTU000072947Medicare PIN
UT107001405101OtherINTRMTN. HEALTH CARE
UT942938348MC4OtherEDUCATORS MUTUAL
UT500012492OtherRAILROAD MEDICARE