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General NPI Number Information
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NPI Number | 1003700873
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Entity Type | Individual
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Provider Name | MICHELLE ALICIA COY DNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2080 CHILD ST DEPT 5000
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City | JACKSONVILLE
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State | FL
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Zip | 32214-5000
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Country | US
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Telephone | 904-542-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 428 S VINE ST
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City | PLAINFIELD
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State | IN
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Zip | 46168-1424
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Country | US
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Telephone | 317-431-1028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11040768
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License Number State | FL
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