MEDICARE: TIFFANY NICOLE TURNER-COATS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach	A-3691880	CA

General Provider Information

NPI Number	:	1447022405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY NICOLE TURNER-COATS

Provider Business Mailing Address
First Line	:	317 N INDIANWOOD AVE
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-2126
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 W HOUSTON ST STE A
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-8792
Country	:	US
Telephone Number	:	918-398-4045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/25/2023

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