MEDICARE: YOLANDA COATES FNP-BC

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	163W00000X	Registered Nurse	R219773	MD
2	363LF0000X	Family Nurse Practitioner	R219773	MD

General Provider Information

NPI Number	:	1891391629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA COATES FNP-BC

Provider Business Mailing Address
First Line	:	1498 REISTERSTOWN RD STE 105
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3817
Country	:	US
Telephone Number	:	410-504-7833
Fax Number	:

Provider Business Practice Location Address
First Line	:	1498 REISTERSTOWN RD STE 1051498
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3817
Country	:	US
Telephone Number	:	410-504-7833
Fax Number	:

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

Provider Enumeration Date	:	12/08/2020
Last Update Date	:	07/01/2025

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