MEDICARE: BETTY L COATES

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1447502539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY L COATES

Provider Business Mailing Address
First Line	:	1335 SARATOGA AVE NE APT 6
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1937
Country	:	US
Telephone Number	:	202-650-2075
Fax Number	:

Provider Business Practice Location Address
First Line	:	1335 SARATOGA AVE NE APT #6
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1937
Country	:	US
Telephone Number	:	202-650-2075
Fax Number	:

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

Provider Enumeration Date	:	10/12/2012
Last Update Date	:	10/12/2012

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Directions to “ BETTY L COATES ” Practice Location

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