Healthcare Provider Details

I. General information

NPI: 1609018977
Provider Name (Legal Business Name): MELISSA BRADBURY COATS N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10250 N 92ND ST STE 114
SCOTTSDALE AZ
85258-4518
US

IV. Provider business mailing address

10250 N 92ND ST STE 114
SCOTTSDALE AZ
85258-4518
US

V. Phone/Fax

Practice location:
  • Phone: 480-990-1111
  • Fax: 480-990-1110
Mailing address:
  • Phone: 480-990-1111
  • Fax: 480-990-1110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number09-1101
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: