Provider Demographics
NPI:1831239706
Name:MCCOY, VAN EVERETTE (BSN, MSA)
Entity type:Individual
Prefix:
First Name:VAN
Middle Name:EVERETTE
Last Name:MCCOY
Suffix:
Gender:M
Credentials:BSN, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAHC STUTTGART, CMR 480, BOX 1765
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09128
Mailing Address - Country:DE
Mailing Address - Phone:49711-680-8615
Mailing Address - Fax:49711-680-8619
Practice Address - Street 1:USAHC STUTTGART, CMR 480, BOX 1765
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09128
Practice Address - Country:DE
Practice Address - Phone:49711-680-8615
Practice Address - Fax:49711-680-8619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC107144163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical