Provider Demographics
NPI:1265151237
Name:MCCOY, MEGARY ROSE (CRNP)
Entity type:Individual
Prefix:
First Name:MEGARY
Middle Name:ROSE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3606
Mailing Address - Country:US
Mailing Address - Phone:302-757-1796
Mailing Address - Fax:
Practice Address - Street 1:111 S 11TH ST BLDG SUITE607
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6996
Practice Address - Fax:215-955-6010
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN694849163W00000X
PASP026544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse