MEDICARE: DR. SHANA MICHELLE COONS DNP-FNP

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	363LF0000X	Family Nurse Practitioner	95029963	CA

General Provider Information

NPI Number	:	1861248767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANA MICHELLE COONS DNP-FNP

Provider Business Mailing Address
First Line	:	303 S BALDWIN AVE APT C
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-3309
Country	:	US
Telephone Number	:	760-402-8688
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 S BALDWIN AVE APT C
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-3309
Country	:	US
Telephone Number	:	760-402-8688
Fax Number	:

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

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	04/30/2024

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