Doctor Name: | SAVANNAH COIN |
NPI Number: | 1043692528 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 2015019741 |
Business Practice Address: | 1301 1st St Kennett, MO - 638572525 |
Business Phone Number: | 5738888413 |
Business Fax Number: | |
Mailing Address: | 1301 1st St, KENNETT |
State: | MO |
Postal Code: | 638572525 |
Phone Number: | 5738888413 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2015 |
NPI Last Update Date: | 06/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015019741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |