Healthcare Provider Details

I. General information

NPI: 1437078185
Provider Name (Legal Business Name): DENNIS JAMES COTO JR. FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17007 HIGHWAY 67
STATESBORO GA
30458-2426
US

IV. Provider business mailing address

23 J BIRD LN
STATESBORO GA
30461-7161
US

V. Phone/Fax

Practice location:
  • Phone: 912-681-2500
  • Fax:
Mailing address:
  • Phone: 912-656-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP274618
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: