Provider Demographics
NPI:1467806554
Name:MCCOY, KAREN FAITH (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:FAITH
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 1:111A BERRY AVE
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1307
Mailing Address - Country:US
Mailing Address - Phone:864-801-2034
Mailing Address - Fax:864-801-2037
Practice Address - Street 1:111A BERRY AVE
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1307
Practice Address - Country:US
Practice Address - Phone:864-801-2034
Practice Address - Fax:864-801-2037
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC208709163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management