Provider Demographics
NPI:1710645601
Name:MCCOY, OLIVIA CATHERINE (ARNP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CATHERINE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:CATHERINE
Other - Last Name:BRINEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:717 N 18TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-1161
Mailing Address - Country:US
Mailing Address - Phone:641-895-9635
Mailing Address - Fax:
Practice Address - Street 1:717 N 18TH ST STE 7
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1161
Practice Address - Country:US
Practice Address - Phone:641-436-2232
Practice Address - Fax:641-222-1671
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG185968363LP0808X
IAA166756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health