MEDICARE: MR. PAUL B COATS RN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	100188	MT
2	363L00000X	Nurse Practitioner	RN16696	MT

General Provider Information

NPI Number	:	1093761652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL B COATS RN, FNP

Provider Business Mailing Address
First Line	:	200 COMMONS WAY STE C
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1915
Country	:	US
Telephone Number	:	406-752-5095
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 COMMONS WAY STE C
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1915
Country	:	US
Telephone Number	:	406-752-5095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	11/27/2023

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Directions to “ MR. PAUL B COATS RN, FNP” Practice Location

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