Provider Demographics
NPI:1427117852
Name:COAKLEY, KAREN (PMHNP; APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:COAKLEY
Suffix:
Gender:F
Credentials:PMHNP; APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 NW 2ND LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3942
Mailing Address - Country:US
Mailing Address - Phone:561-512-4447
Mailing Address - Fax:561-330-3410
Practice Address - Street 1:6426 MELALEUCA LN
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3807
Practice Address - Country:US
Practice Address - Phone:561-444-3512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9166242363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8887XMedicare ID - Type Unspecified
FLK4871Medicare ID - Type Unspecified
FLP83614Medicare UPIN