Provider Demographics
NPI:1811239783
Name:COY, SUNNY DYER (CRNA)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:DYER
Last Name:COY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 HEMBY LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3701
Mailing Address - Country:US
Mailing Address - Phone:252-752-2140
Mailing Address - Fax:888-787-2249
Practice Address - Street 1:2485 HEMBY LN
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3701
Practice Address - Country:US
Practice Address - Phone:252-752-2140
Practice Address - Fax:888-787-2249
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC217035163W00000X
NC92818367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1811239783Medicaid
NC1811239783OtherTRICARE
NCQ43678AMedicare PIN