Provider Demographics
NPI:1013985225
Name:MCCOY, HANNAH (NP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:DRIGGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 S GLOSTER ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4996
Mailing Address - Country:US
Mailing Address - Phone:606-327-4000
Mailing Address - Fax:662-377-2920
Practice Address - Street 1:830 S GLOSTER ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4996
Practice Address - Country:US
Practice Address - Phone:606-327-4000
Practice Address - Fax:662-377-2920
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3-001836363LF0000X
MS888837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P36755Medicare UPIN