Diane Marie Coughlan, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP011208 Issued in PA

Practice address

4115 Chichester Ave
Upper Chichester, PA 19061-3139

Phone

(610) 484-4422

NPI assigned

Dec 29, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tapestry Telehealth PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1992215446

  Nurse Practitioner

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1124322508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 CHICHESTER AVE",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613139",
            "telephone_number": "610-484-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 CHICHESTER AVE",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613139",
            "telephone_number": "610-484-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLAN",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald Combs Harris, MSW, LCSW
• Communities of Don Guanella and Divine Providence
• Alexis Conte
• Corelife Valley, LLC
• Patricia Costello, MS, RDN, LDN
• Susan D'Alessandris, OTR/L
• Kadiatou Dabo
• Joanne Damico, RPH
• Hayden Davis, OD
• Delaware Valley Home Care, Inc.

• Nurse Practitioner in Upper Chichester, PA
• Providers in Upper Chichester, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.