Provider Demographics
NPI:1700516069
Name:COATS, JANE (APRN/PSYCHIATRY)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:COATS
Suffix:
Gender:F
Credentials:APRN/PSYCHIATRY
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ANN
Other - Last Name:CALLAHAN COATS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:99 W SOUTH TEMPLE UNIT 706
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-4727
Mailing Address - Country:US
Mailing Address - Phone:801-580-7744
Mailing Address - Fax:
Practice Address - Street 1:273 N EAST CAPITOL ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-4622
Practice Address - Country:US
Practice Address - Phone:801-580-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT203474-8900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health