Provider Demographics
NPI:1649351693
Name:COATNEY, MARY ANN T (CNM, APRN-BC (FNP))
Entity type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:T
Last Name:COATNEY
Suffix:
Gender:F
Credentials:CNM, APRN-BC (FNP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:17651 B HWY
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-2839
Mailing Address - Country:US
Mailing Address - Phone:660-882-7461
Mailing Address - Fax:660-882-6093
Practice Address - Street 1:600 W MORRISON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1075
Practice Address - Country:US
Practice Address - Phone:660-248-2900
Practice Address - Fax:660-248-1544
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO095341363LF0000X, 367A00000X
KS64090367A00000X
NYF001103-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife