Provider Demographics
NPI:1902278575
Name:COYLE, DENISE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:COYLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4060
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:104 TECHNOLOGY DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-6062
Practice Address - Country:US
Practice Address - Phone:724-482-6062
Practice Address - Fax:724-482-6117
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015488363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030693600001Medicaid
PA1030693600001Medicaid