Provider Demographics
NPI:1295783553
Name:COY- MCFARLANE, ANNETTE (APRN BC)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:COY- MCFARLANE
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 W COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4325
Mailing Address - Country:US
Mailing Address - Phone:954-475-5500
Mailing Address - Fax:954-625-8772
Practice Address - Street 1:9800 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33351-4325
Practice Address - Country:US
Practice Address - Phone:954-475-5500
Practice Address - Fax:954-625-8772
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV56796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0243001000Medicaid
WVNP15041Medicare ID - Type Unspecified