Provider Demographics
NPI:1780619551
Name:COYNE, KELLY DELANEY (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:DELANEY
Last Name:COYNE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4145 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1451
Mailing Address - Country:US
Mailing Address - Phone:708-784-3423
Mailing Address - Fax:773-880-3019
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 30
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-975-8643
Practice Address - Fax:773-880-3019
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL163WP0218X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology