Provider Demographics
NPI:1710645601
Name:MCCOY, OLIVIA CATHERINE (ARNP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CATHERINE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:CATHERINE
Other - Last Name:BRINEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26261 545TH ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-8368
Mailing Address - Country:US
Mailing Address - Phone:641-895-9635
Mailing Address - Fax:
Practice Address - Street 1:26261 545TH ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-8368
Practice Address - Country:US
Practice Address - Phone:641-895-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA166756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily