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NPI Code Detail

MEDICARE: TINA SHELTON-COOMER APRN

MEDICARE: TINA SHELTON-COOMER APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3012895KY

General Provider Information

NPI Number : 1821569393
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA SHELTON-COOMER APRN
Provider Business Mailing Address
First Line : 10200 ALLIANCE RD STE 150
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4754
Country : US
Telephone Number : 139-754-6743
Fax Number :
Provider Business Practice Location Address
First Line : 1030 MONARCH ST STE 100
Second Line :
City : LEXINGTON
State : KY
Zip : 40513-1820
Country : US
Telephone Number : 216-468-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2018
Last Update Date : 01/28/2021

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Directions to “ TINA SHELTON-COOMER APRN” Practice Location

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