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Individual

MRS. THERESA A COOMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
161A MARINE ST, ST AUGUSTINE, FL 32084-5154
(904) 806-5273
Mailing address
600 KINGS ESTATE RD, ST AUGUSTINE, FL 32086-5336
(904) 806-5273

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
715622
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
303938100
FL
Enumeration date
01/16/2007
Last updated
11/07/2011
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