Provider Demographics
NPI:1528190089
Name:MCCOY, HEATHER O'HARA (DRNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:O'HARA
Last Name:MCCOY
Suffix:
Gender:F
Credentials:DRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14106 E CAREFREE HWY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-5803
Mailing Address - Country:US
Mailing Address - Phone:480-338-6633
Mailing Address - Fax:
Practice Address - Street 1:15169 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 350
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2429
Practice Address - Country:US
Practice Address - Phone:480-758-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN088543363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health