MEDICARE: ERICA LYNN COYNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110009308	VA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1114510336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYNN COYNE

Provider Business Mailing Address
First Line	:	3022 W BROAD ST APT 536
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-5120
Country	:	US
Telephone Number	:	484-832-3087
Fax Number	:

Provider Business Practice Location Address
First Line	:	7611 FOREST AVE STE 320
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4946
Country	:	US
Telephone Number	:	804-285-8206
Fax Number	:	804-497-5469

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	12/12/2025

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Directions to “ ERICA LYNN COYNE ” Practice Location

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