Provider Demographics
NPI:1619939451
Name:COATE, KATHERINE T (NP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:T
Last Name:COATE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:T
Other - Last Name:ALKIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-4700
Mailing Address - Fax:208-367-4705
Practice Address - Street 1:600 E STATE ST
Practice Address - Street 2:STE 200
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6081
Practice Address - Country:US
Practice Address - Phone:208-367-4700
Practice Address - Fax:208-367-4705
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP276A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDNPJA7OtherBLUE CROSS
ID004358500Medicaid
ID000010135254OtherBLUE SHIELD