Individual
MINDY DAWN COAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
4100 JACKSON AVE, AUSTIN, TX 78731-6056
(512) 454-4711
Mailing address
2203A LANIER DR, AUSTIN, TX 78757-7738
(512) 560-3367
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
756883
TX
163WH1000X
Hospice Registered Nurse
756883
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP144899
TX
363LG0600X
Gerontology Nurse Practitioner
AP144899
TX
363LP2300X
Primary Care Nurse Practitioner
AP144899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
388821601
—
TX
Enumeration date
08/01/2018
Last updated
02/03/2020
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