=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770916751
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN ELIZABETH COAKLEY F.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2013
-----------------------------------------------------
Last Update Date | 08/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45 RESNIK RD SUITE 303
-----------------------------------------------------
City | PLYMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02360-4844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-746-7858
-----------------------------------------------------
Fax | 508-747-1153
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 RESNIK RD SUITE 303
-----------------------------------------------------
City | PLYMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02360-4844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-746-7858
-----------------------------------------------------
Fax | 508-747-1153
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN2277497
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------