Individual
TENNILLE COAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1018 SHILOH RD, MILTON, WV 25541-9556
(660) 351-5714
Mailing address
1018 SHILOH RD, MILTON, WV 25541-9556
(660) 351-5714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
103600
WV
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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