=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982009056
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCY COATES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2014
-----------------------------------------------------
Last Update Date | 06/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 230 E JAMES CAMPBELL BLVD STE 101 & 102
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-840-9588
-----------------------------------------------------
Fax | 931-381-3519
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 190
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37065-0190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-840-9588
-----------------------------------------------------
Fax | 931-381-3519
-----------------------------------------------------
=====================================================
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 | APN9080
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------