Provider Demographics
NPI:1477227734
Name:COFFIELD, KYLIE A (PAC)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:A
Last Name:COFFIELD
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:A
Other - Last Name:HONNICK-PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:801 OSTRUM ST # STREET2
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-1735
Mailing Address - Fax:
Practice Address - Street 1:801 OSTRUM ST # STREET2
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062947363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant