MEDICARE: MS. LAURA L COE 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	363LF0000X	Family Nurse Practitioner	RN063560	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972696060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA L COE FNP-BC

Provider Business Mailing Address
First Line	:	4831 N 11TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-3622
Country	:	US
Telephone Number	:	602-424-2101
Fax Number	:	604-424-2103

Provider Business Practice Location Address
First Line	:	4831 N 11TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-3622
Country	:	US
Telephone Number	:	602-424-2101
Fax Number	:	604-424-2103

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/27/2015

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