Healthcare Provider Details

I. General information

NPI: 1467238287
Provider Name (Legal Business Name): STEPHANIE M COATS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 10/05/2026
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E MCDOWELL RD
PHOENIX AZ
85006
US

IV. Provider business mailing address

925 E MCDOWELL RD
PHOENIX AZ
85006
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3682
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number301096
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA176525
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61542452
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number149621
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: