Healthcare Provider Details

I. General information

NPI: 1487475513
Provider Name (Legal Business Name): MRS. ANNETTE COES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 CLAY ST
GARY IN
46403-2811
US

IV. Provider business mailing address

623 CLAY ST
GARY IN
46403-2811
US

V. Phone/Fax

Practice location:
  • Phone: 219-545-3207
  • Fax:
Mailing address:
  • Phone: 219-545-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number25-018955-1
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: