Provider Demographics
NPI:1184972333
Name:COYNE, TARA M (NP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:M
Last Name:COYNE
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Gender:F
Credentials:NP
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Mailing Address - Street 1:219 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5524
Mailing Address - Country:US
Mailing Address - Phone:781-322-7300
Mailing Address - Fax:781-322-0075
Practice Address - Street 1:600 CLARK RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1699
Practice Address - Country:US
Practice Address - Phone:978-458-6900
Practice Address - Fax:978-458-1670
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2024-07-01
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Provider Licenses
StateLicense IDTaxonomies
MARN273635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily