Provider Demographics
NPI:1053496059
Name:COATS, VANESSA BOWEN (RXN, CNS)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:BOWEN
Last Name:COATS
Suffix:
Gender:F
Credentials:RXN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CLERMONT ST
Mailing Address - Street 2:3E-115C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3808
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:3E-115C
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60789163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0364084-01OtherANCC CRED. ADULT PSYCH
CO3435OtherCOLO. ADV. PRACTICE REG.
CO18176038Medicaid
CO60789OtherRN LICENSE
CO60789OtherCOLORADO NURSING LICENSE
CO60789OtherCOLORADO NURSING LICENSE
CO60789OtherRN LICENSE