Healthcare Provider Details

I. General information

NPI: 1952701336
Provider Name (Legal Business Name): VENESSA A COAKE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 RESEARCH CENTER DR STE A
BLACKSBURG VA
24060-6325
US

IV. Provider business mailing address

4942 E LEE HWY
MAX MEADOWS VA
24360-3428
US

V. Phone/Fax

Practice location:
  • Phone: 540-381-5291
  • Fax: 540-381-7857
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172413
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number139063
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: