DORENE MARY MCCOY APRN NPI 1063934123

NPI Information

NPI: 1063934123
Provider Name: DORENE MARY MCCOY, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: LEE MEMORIAL HEALTH SYSTEM

PECOS Registration: Yes

Address:
9981 S HEALTHPARK DR STE 156
FORT MYERS, FL
ZIP 33908
Phone: (239) 343-6341
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Dorene Mary Mccoy, APRN is a family nurse practitioner in Fort Myers, FL with 7 years of experience. Dorene Mary Mccoy, APRN NPI is 1063934123. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9981 S HEALTHPARK DR STE 156
FORT MYERS, FL
ZIP 33908-618
Phone: (239) 343-6341
Fax: (239) 343-6342

The NPI 1063934123 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/11/2017 and was last updated on 3/31/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APRN9207021	FLORIDA	Yes
2	364SM0705X	Clinical Nurse Specialist	Medical-Surgical	APRN9207021	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	021715100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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