Provider Demographics
NPI:1578800967
Name:NEECE, COETTA LYNN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:COETTA
Middle Name:LYNN
Last Name:NEECE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:PROF
Other - First Name:COETTA
Other - Middle Name:LYNN
Other - Last Name:NEECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 301
Mailing Address - Street 2:
Mailing Address - City:NORA
Mailing Address - State:VA
Mailing Address - Zip Code:24272
Mailing Address - Country:US
Mailing Address - Phone:276-597-6326
Mailing Address - Fax:276-597-6300
Practice Address - Street 1:18334 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614
Practice Address - Country:US
Practice Address - Phone:276-597-6326
Practice Address - Fax:276-597-6300
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily