Basic Information
| Provider Information | |||||||||
| NPI: | 1235157918 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCOY | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNSC, APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3919 PLANTATION DR | ||||||||
| Address2: | |||||||||
| City: | COOKEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385066101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9315372267 | ||||||||
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| Practice Location | |||||||||
| Address1: | 446 METROPLEX DR | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372113139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157810013 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 06/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 6797 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.