Provider Demographics
NPI:1376274209
Name:COE, PRESCOTT MARTIN WESTLY (MSN, RN, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:PRESCOTT
Middle Name:MARTIN WESTLY
Last Name:COE
Suffix:
Gender:M
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6433 WESTBOURN CIR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5850
Mailing Address - Country:US
Mailing Address - Phone:727-514-8069
Mailing Address - Fax:
Practice Address - Street 1:6433 WESTBOURN CIR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5850
Practice Address - Country:US
Practice Address - Phone:727-514-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1685406363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health