Healthcare Provider Details

I. General information

NPI: 1073006870
Provider Name (Legal Business Name): HOLLY JO COCCIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 PITTSBURGH MCKEESPORT BLVD
WEST MIFFLIN PA
15122-2849
US

IV. Provider business mailing address

814 PITTSBURGH MCKEESPORT BLVD
WEST MIFFLIN PA
15122-2849
US

V. Phone/Fax

Practice location:
  • Phone: 412-476-6146
  • Fax: 412-476-6466
Mailing address:
  • Phone: 412-476-6146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP005770B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: