Provider Demographics
NPI:1437992419
Name:COYLE, CAROLINE MCDONALD (NP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MCDONALD
Last Name:COYLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:PRINCE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43943 CHELTENHAM CIR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6565 ARLINGTON BLVD STE 420
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3028
Practice Address - Country:US
Practice Address - Phone:703-534-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189824363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty