Provider Demographics
NPI:1548077233
Name:COATS, ISABELLA BUENCONSEJO
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:BUENCONSEJO
Last Name:COATS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E COLISEUM BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-1499
Mailing Address - Country:US
Mailing Address - Phone:260-257-6831
Mailing Address - Fax:
Practice Address - Street 1:2101 E COLISEUM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-1499
Practice Address - Country:US
Practice Address - Phone:260-257-6831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program