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General NPI Number Information
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NPI Number | 1356924740
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Entity Type | Organization
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Legal Business Name | COASTAL PREMIER MEDICAL CARE
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 15450 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34110-6217
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Country | US
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Telephone | 239-778-0723
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Fax |
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Provider Business Mailing Address
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Address Line | 340 TAMIAMI TRL N PMB 162
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City | NAPLES
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State | FL
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Zip | 34102-5803
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Country | US
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Telephone | 239-316-3323
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | LAURA L JONES
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Credential | ARNP
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Telephone | 614-738-2161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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