Healthcare Provider Details

I. General information

NPI: 1417469867
Provider Name (Legal Business Name): PATRICIA COE HOOSIER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 JOHNSON RIDGE MEDICAL PARK
ELKIN NC
28621-2447
US

IV. Provider business mailing address

400 JOHNSON RIDGE MEDICAL PARK
ELKIN NC
28621-2447
US

V. Phone/Fax

Practice location:
  • Phone: 336-526-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009952
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: