Provider Demographics
NPI:1518725605
Name:MCCOY, ANASTASIA CRYSTAL (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:CRYSTAL
Last Name:MCCOY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HONEYLOCUST CIR
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-7138
Mailing Address - Country:US
Mailing Address - Phone:215-218-8188
Mailing Address - Fax:
Practice Address - Street 1:111 W HIGH ST STE 214
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-8611
Practice Address - Country:US
Practice Address - Phone:410-996-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218704163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse