MEDICARE: MARIA REGINA 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	363LG0600X	Gerontology Nurse Practitioner	APN	CO
2	363LA2100X	Acute Care Nurse Practitioner	APN.0999276-NP	CO

General Provider Information

NPI Number	:	1902653728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA REGINA COATES

Provider Business Mailing Address
First Line	:	2038 SHORELINE CT
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-4648
Country	:	US
Telephone Number	:	702-884-3676
Fax Number	:

Provider Business Practice Location Address
First Line	:	4850 HAHNS PEAK DR UNIT 100
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-6001
Country	:	US
Telephone Number	:	970-330-5655
Fax Number	:

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

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	05/06/2024

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