Provider Demographics
NPI:1821773433
Name:COASTAL CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:COASTAL CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-490-6419
Mailing Address - Street 1:204 STAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2768
Mailing Address - Country:US
Mailing Address - Phone:410-490-6419
Mailing Address - Fax:
Practice Address - Street 1:204 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2768
Practice Address - Country:US
Practice Address - Phone:410-490-6419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility