| NPI | 1104234012 |
|---|---|
| Former Name | SHELLEY LYNN MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN656377) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2019-01-28 |