Basic Information
| Provider Information | |||||||||
| NPI: | 1356654289 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUELLER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | COYLE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP, FNP-BC, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT ST | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556180 | ||||||||
| FaxNumber: | 2159556410 | ||||||||
| Practice Location | |||||||||
| Address1: | 833 CHESTNUT ST | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556180 | ||||||||
| FaxNumber: | 2159556410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2010 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN1268 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163W00000X | 26NR14592700 | NJ | N | Nursing Service Providers | Registered Nurse | 163W00000X | 708142 | CA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | APN001268 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | RN65986 | NV | N | Nursing Service Providers | Registered Nurse | 363L00000X | SP012621 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1356654289 | 05 | NV | MEDICAID | 102896526 | 05 | PA | MEDICAID |