Provider Demographics
NPI:1255941399
Name:COATES, STEPHLYNN MIA
Entity type:Individual
Prefix:MS
First Name:STEPHLYNN
Middle Name:MIA
Last Name:COATES
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 1:1601 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-9308
Mailing Address - Country:US
Mailing Address - Phone:937-344-6748
Mailing Address - Fax:
Practice Address - Street 1:1601 AZALEA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-9308
Practice Address - Country:US
Practice Address - Phone:937-344-6748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No385H00000XRespite Care FacilityRespite Care