Individual
TERESA MARYA COYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
23225 LORAIN, N OLMSTEAD, OH 44070
(440) 779-6900
(440) 779-8091
Mailing address
6401 W 54TH ST, PARMA, OH 44129
(440) 842-6744
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP06998
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374980
BLUE SHIELD
OH
05
—
2334067
—
OH
01
—
P00222386
RR MEDICARE
OH
Enumeration date
09/12/2006
Last updated
07/08/2007
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