Provider Demographics
NPI:1578992574
Name:COYNE, DEBRA (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:COYNE
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 1:1720 2ND AVE S
Mailing Address - Street 2:FOT 930B
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0004
Mailing Address - Country:US
Mailing Address - Phone:205-975-4667
Mailing Address - Fax:205-934-8720
Practice Address - Street 1:1720 2ND AVE S
Practice Address - Street 2:FOT 930B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0004
Practice Address - Country:US
Practice Address - Phone:205-975-4667
Practice Address - Fax:205-934-8720
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-048429363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner