Provider Demographics
NPI:1598382392
Name:MCCOY, HEATHER SUE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:SUE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 NATIONAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7572
Mailing Address - Country:US
Mailing Address - Phone:405-733-9500
Mailing Address - Fax:405-732-1060
Practice Address - Street 1:8121 NATIONAL AVE STE 400
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7572
Practice Address - Country:US
Practice Address - Phone:405-733-9500
Practice Address - Fax:405-732-1060
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0095969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily