Provider Demographics
NPI:1982814810
Name:KOYL, PATTY ANN (NP)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:KOYL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4096 W 229TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1080
Mailing Address - Country:US
Mailing Address - Phone:440-777-5072
Mailing Address - Fax:440-777-5072
Practice Address - Street 1:5900 CARGO RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-3110
Practice Address - Country:US
Practice Address - Phone:216-501-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH167665363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health