Individual
COYOTE R CAPASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
106 N MAIN ST, NEW CARLISLE, OH 45344-1835
(937) 667-1122
Mailing address
106 N MAIN ST, NEW CARLISLE, OH 45344-1835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
APRN.CNP.025985
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.025985
OH
Other
Enumeration date
10/27/2020
Last updated
01/07/2022
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