| NPI | 1841739125 |
|---|---|
| Former Name | CALLIE JO MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010945) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174414) |
| Enumeration Date | 2017-02-19 |
| Last Update Date | 2022-06-09 |