Healthcare Provider Details

I. General information

NPI: 1598335721
Provider Name (Legal Business Name): MICHAEL J COCCIA DNP, AGACNP, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

IV. Provider business mailing address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3411
  • Fax:
Mailing address:
  • Phone: 205-934-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number30295
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP035245
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3-000740
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number235114
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberGAA-NP004081
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number245447
License Number StateLA
# 7
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3-000740
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: