Provider Demographics
NPI:1164237905
Name:MCCOY, ERIN ROSE (FNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 WARREN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1432
Mailing Address - Country:US
Mailing Address - Phone:401-606-1004
Mailing Address - Fax:401-606-1153
Practice Address - Street 1:950 WARREN AVE STE 201
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1432
Practice Address - Country:US
Practice Address - Phone:401-606-1004
Practice Address - Fax:401-606-1153
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner