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NPI Code Detail

MEDICARE: MARTHA C COATES NP

MEDICARE: MARTHA C COATES NP
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
1363L00000XNurse PractitionerSP012579PA
2363LA2200XAdult Health Nurse PractitionerSP012579PA
3363LG0600XGerontology Nurse PractitionerSP012895PA

General Provider Information

NPI Number : 1609118249
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA C COATES NP
Provider Business Mailing Address
First Line : 10000 SHANNONDELL DR
Second Line :
City : AUDUBON
State : PA
Zip : 19403-5615
Country : US
Telephone Number : 610-728-5241
Fax Number : 610-728-5322
Provider Business Practice Location Address
First Line : 10000 SHANNONDELL DR
Second Line :
City : AUDUBON
State : PA
Zip : 19403-5615
Country : US
Telephone Number : 610-728-5241
Fax Number : 610-728-5322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2013
Last Update Date : 09/30/2014

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