Provider Demographics
NPI:1720849003
Name:COEUILLE, CANDI ANN (RN)
Entity Type:Individual
Prefix:
First Name:CANDI
Middle Name:ANN
Last Name:COEUILLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 116TH AVE NE STE 600
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4623
Mailing Address - Country:US
Mailing Address - Phone:425-454-2656
Mailing Address - Fax:
Practice Address - Street 1:1135 116TH AVE NE STE 600
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4623
Practice Address - Country:US
Practice Address - Phone:425-454-2656
Practice Address - Fax:425-455-2620
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60545520163W00000X
WAAP61526728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse