Healthcare Provider Details

I. General information

NPI: 1659202505
Provider Name (Legal Business Name): NICOLE PIEPER COAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STATE ROAD 54
TRINITY FL
34655-1808
US

IV. Provider business mailing address

9330 STATE ROAD 54
TRINITY FL
34655-1808
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4275
  • Fax:
Mailing address:
  • Phone: 727-834-4275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP1700X
TaxonomyPerinatal Clinical Nurse Specialist
License NumberRN9348818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: