Provider Demographics
NPI:1144986415
Name:COE, BRITTNEY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:COE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PASEO DEL PUEBLO SUR STE 125
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-7024
Mailing Address - Country:US
Mailing Address - Phone:575-751-7430
Mailing Address - Fax:
Practice Address - Street 1:630 PASEO DEL PUEBLO SUR STE 125
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-7024
Practice Address - Country:US
Practice Address - Phone:575-751-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2021-0099363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant