Doctor Name: | THOMAS EUGENE COEHLO |
NPI Number: | 1003890351 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RN, MSN, FNP-C |
License Number: | 090007430N1 |
Business Practice Address: | 2190 Ne Professional Ct Suite 250 Bend, OR - 977016985 |
Business Phone Number: | 5413855515 |
Business Fax Number: | 5413855578 |
Mailing Address: | 2190 Ne Professional Ct, Suite 250 BEND |
State: | OR |
Postal Code: | 977016985 |
Phone Number: | 5413855515 |
Fax Number: | 5413855578 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 05/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 090007430N1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |