Provider Demographics
NPI:1134294895
Name:COY, CAROL A (CRNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:COY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 HIGBEE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2522
Mailing Address - Country:US
Mailing Address - Phone:330-493-0313
Mailing Address - Fax:330-493-9349
Practice Address - Street 1:5000 HIGBEE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2522
Practice Address - Country:US
Practice Address - Phone:330-493-0313
Practice Address - Fax:330-493-9349
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP02015363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P27642Medicare UPIN