Provider Demographics
NPI:1710750658
Name:MCCOY, CYNTHIA ROCHELLE
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ROCHELLE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 N BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6607
Mailing Address - Country:US
Mailing Address - Phone:509-496-7949
Mailing Address - Fax:
Practice Address - Street 1:5934 N BUFFALO ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6607
Practice Address - Country:US
Practice Address - Phone:509-496-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60990812376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide