Provider Demographics
NPI:1184824005
Name:COE, CHARITY OAKS (PA-C)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:OAKS
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:UNIVERSITY OF UTAH MEDICAL CENTER TRAUMA SERVICE
Mailing Address - Street 2:50 NORTH MEDICAL DRIVE
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:443-690-6996
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF UTAH MEDICAL CENTER TRAUMA SERVICE
Practice Address - Street 2:50 NORTH MEDICAL DRIVE
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:443-690-6996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003391363A00000X
UT5744061-1206363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant