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NPI Code Detail

MEDICARE: MRS. SALLIE P COKE MSN

MEDICARE: MRS. SALLIE P COKE MSN
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
1363LP0200XPediatric Nurse PractitionerRN097198GA
2363LF0000XFamily Nurse PractitionerRN097198GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942295431
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SALLIE P COKE MSN
Provider Business Mailing Address
First Line : 7429 HWY 41 S
Second Line :
City : MACON
State : GA
Zip : 31210-5347
Country : US
Telephone Number : 478-994-2026
Fax Number :
Provider Business Practice Location Address
First Line : 101 HOUSTON ST
Second Line :
City : BARNESVILLE
State : GA
Zip : 30204-1660
Country : US
Telephone Number : 770-358-1961
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 07/08/2010

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Directions to “ MRS. SALLIE P COKE MSN” Practice Location

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