Healthcare Provider Details

I. General information

NPI: 1437233723
Provider Name (Legal Business Name): TERRIE ANN COLES F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NEVIN AVE DEPARTMENT OF OCCUPATIONAL MEDICINE
RICHMOND CA
94801-3143
US

IV. Provider business mailing address

191 CIRCLE AVE
MILL VALLEY CA
94941-1296
US

V. Phone/Fax

Practice location:
  • Phone: 510-307-2579
  • Fax:
Mailing address:
  • Phone: 415-388-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number446929
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number6948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: