Coakley, Mindy Dawn

Coakley, Mindy Dawn is an sole proprietor health care provider with primary practice located at 4100 Jackson Ave , Austin TX 78731-6056. She recently has 5 registered licenses in different health care specialties including Nursing Service Providers / Home Health, Nursing Service Providers / Hospice, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Coakley, Mindy Dawn can be contacted via phone (512) 454-4711.

Contact Information

Primary practice address
4100 Jackson Ave Austin TX 78731-6056
Phone: (512) 454-4711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Home Health 163WH0200X 756883 Texas
Nursing Service Providers / Hospice 163WH1000X 756883 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP144899 Texas
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP144899 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP144899 Texas

Profile Details

NPI number 1811475809
LBN Legal business name Coakley, Mindy Dawn
Credentials AGNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2018
Last updated Feb 3rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811475809 NPPES
Texas MEDICAID 388821601

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