=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346814340
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBRA ALYNN COATY RN, CNM, RXN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2021
-----------------------------------------------------
Last Update Date | 07/02/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8000 E PRENTICE AVE STE D10
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-2728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-309-3660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9368 YUCCA WAY
-----------------------------------------------------
City | ARVADA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80007-7364
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-868-2989
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | RN.0097009
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | APN.0002136-CNM
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------