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General NPI Number Information
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NPI Number | 1619142320
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Entity Type | Individual
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Provider Name | PENNI RENE COATES DNP, APRN, NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 828-320-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 828-320-5125
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5001625
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 201268
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License Number State | NC
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