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General NPI Number Information
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NPI Number | 1578800967
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Entity Type | Individual
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Provider Name | COETTA LYNN NEECE NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 18334 RIVERSIDE DRIVE
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City | GRUNDY
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State | VA
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Zip | 24614
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Country | US
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Telephone | 276-597-6326
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Fax | 276-597-6300
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Provider Business Mailing Address
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Address Line | P.O. BOX 301
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City | NORA
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State | VA
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Zip | 24272
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Country | US
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Telephone | 276-597-6326
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Fax | 276-597-6300
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0024170561
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License Number State | VA
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