Provider Demographics
NPI:1043302169
Name:COKER, LYNETTE HARDY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:HARDY
Last Name:COKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 PIN BROOK LN
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1601
Mailing Address - Country:US
Mailing Address - Phone:205-464-0309
Mailing Address - Fax:
Practice Address - Street 1:937 PIN BROOK LN
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1601
Practice Address - Country:US
Practice Address - Phone:205-464-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-076029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner