Dylan Mackenzie Coyne, RN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95015595 Issued in CA

Practice address

1885 Bay Rd
East Palo Alto, CA 94303-1312

Phone

(650) 330-7400

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1346859436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 GRAND ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621634",
            "telephone_number": "650-773-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031312",
            "telephone_number": "650-330-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "DYLAN",
        "middle_name": "MACKENZIE",
        "credential": "RN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95015595",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95172478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in East Palo Alto, CA
• Providers in East Palo Alto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.