Physician Compare National (NPI:1548763980)

HEALTHCARE PROVIDER: COEVA BARNES GATLIN FNP-BC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1548763980
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618222829
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190424000878
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GATLIN
	Individual professional last name
Provider First Name	COEVA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	220 W GEORGIA AVE
	Group Practice or individual's line 1 address
City	MCCOMB
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	396483222
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	250097
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHWEST MS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y