Provider Demographics
NPI:1629945969
Name:COATS, DESIRE
Entity type:Individual
Prefix:
First Name:DESIRE
Middle Name:
Last Name:COATS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E 2ND ST APT 136
Mailing Address - Street 2:
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-2936
Mailing Address - Country:US
Mailing Address - Phone:308-289-3695
Mailing Address - Fax:
Practice Address - Street 1:1701 E 2ND ST APT 136
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-2936
Practice Address - Country:US
Practice Address - Phone:308-289-3695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide