Provider Demographics
NPI:1144791294
Name:COASTAL APRN MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:COASTAL APRN MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KALIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:321-505-3999
Mailing Address - Street 1:3628 IMPERATA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6093
Mailing Address - Country:US
Mailing Address - Phone:321-505-3999
Mailing Address - Fax:386-492-2949
Practice Address - Street 1:3628 IMPERATA DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6093
Practice Address - Country:US
Practice Address - Phone:321-505-3999
Practice Address - Fax:386-492-2949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty