Provider Demographics
NPI:1255452512
Name:MCCOY, JANIE CAROL (RNC)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:CAROL
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 W RUSS STEPHENS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:GA
Mailing Address - Zip Code:30563-3338
Mailing Address - Country:US
Mailing Address - Phone:706-778-3263
Mailing Address - Fax:
Practice Address - Street 1:1280 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-535-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN049565163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory