Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 71008978A | IN |
NPI | 1295393239 |
---|---|
Provider Name | Andrea Dee Coons |
First Address | Hartford City, IN 47348-9044 |
Second Address | Muncie, IN 47303-3428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2019 |
Last Update Date | 04/06/2019 |