Individual
MARY BETHENY COAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
1120 GROVE RD, GREENVILLE, SC 29605-4656
(864) 455-8897
(864) 455-8555
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
21708
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5875
—
SC
Enumeration date
04/23/2018
Last updated
05/07/2021
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