Provider Demographics
NPI:1508569039
Name:COYNE, KATHRYN GABRIELLE (CLD)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:GABRIELLE
Last Name:COYNE
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NEW BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4756
Mailing Address - Country:US
Mailing Address - Phone:910-621-4266
Mailing Address - Fax:
Practice Address - Street 1:310 NEW BRIDGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4756
Practice Address - Country:US
Practice Address - Phone:910-621-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula