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Individual

HEIDI ANNE COYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA781
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11461608
CAQH
NV
01
PA781
NV LICENSE
NV
Enumeration date
07/12/2011
Last updated
10/16/2014
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