Provider Demographics
NPI:1356654289
Name:MUELLER, REBECCA COYLE (CRNP, FNP-BC, RN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:COYLE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:CRNP, FNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 701
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:215-955-6180
Mailing Address - Fax:215-955-6410
Practice Address - Street 1:833 CHESTNUT ST
Practice Address - Street 2:SUITE 701
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4414
Practice Address - Country:US
Practice Address - Phone:215-955-6180
Practice Address - Fax:215-955-6410
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN1268363L00000X
NJ26NR14592700163W00000X
CA708142163W00000X
NVAPN001268363LF0000X
NVRN65986163W00000X
PASP012621363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1356654289Medicaid
PA102896526Medicaid
NVEW854ZMedicare PIN
PA270053Medicare PIN
NVEW854YMedicare PIN