Healthcare Provider Details

I. General information

NPI: 1902278575
Provider Name (Legal Business Name): DENISE COYLE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 TECHNOLOGY DRIVE SUITE 202
BUTLER PA
16001-6062
US

IV. Provider business mailing address

PO BOX 1549
BUTLER PA
16003-1549
US

V. Phone/Fax

Practice location:
  • Phone: 724-482-6062
  • Fax: 724-482-6117
Mailing address:
  • Phone: 724-284-4060
  • Fax: 724-284-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015488
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP015488
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: