Provider Demographics
NPI:1093902058
Name:COYNE, PAMELA LEA (FNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LEA
Last Name:COYNE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3470 BUSKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4316
Mailing Address - Country:US
Mailing Address - Phone:925-887-5678
Mailing Address - Fax:925-887-5672
Practice Address - Street 1:3470 BUSKIRK AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4316
Practice Address - Country:US
Practice Address - Phone:925-887-5678
Practice Address - Fax:925-887-5672
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492650363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner