Provider Demographics
NPI:1801935580
Name:MCCOY, BARBARA W (MIDWIFE, WHNP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:W
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MIDWIFE, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 FAIRFIELD ROOM 569
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101
Mailing Address - Country:US
Mailing Address - Phone:318-676-7489
Mailing Address - Fax:318-676-7560
Practice Address - Street 1:1525 FAIRFIELD AVE STE 569
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4331
Practice Address - Country:US
Practice Address - Phone:318-676-7489
Practice Address - Fax:318-676-7560
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA033445-1359176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1685402Medicare ID - Type Unspecified
LANPP000Medicare UPIN
LA4B770F600Medicare PIN