Provider Demographics
NPI:1376860502
Name:COKER, SHANA LEA (RN, MSN, AOCNS, ARNP)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:LEA
Last Name:COKER
Suffix:
Gender:F
Credentials:RN, MSN, AOCNS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 10TH ST SE
Mailing Address - Street 2:SUITE 285
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2414
Mailing Address - Country:US
Mailing Address - Phone:319-369-7816
Mailing Address - Fax:319-558-4877
Practice Address - Street 1:202 10TH ST SE
Practice Address - Street 2:SUITE 285
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2414
Practice Address - Country:US
Practice Address - Phone:319-369-7816
Practice Address - Fax:319-558-4877
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAU-094459CNSONCOLOGY363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner