Provider Demographics
NPI:1972044493
Name:MCCOY, LORI S (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:S
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14120 E TEMPLE DR
Mailing Address - Street 2:Y9
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5660
Mailing Address - Country:US
Mailing Address - Phone:507-398-9135
Mailing Address - Fax:
Practice Address - Street 1:2530 S PARKER RD STE 400
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1623
Practice Address - Country:US
Practice Address - Phone:303-306-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO162719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse