Tiasha M Coakley | Middletown, NY • PECOS Search

Tiasha M Coakley

Registered Nurse

Nursing Service Providers

15 James P. Kelly Way, 4, Middletown, NY 10940

PECOS Enrollment

Based on the most recent information from CMS, provider Tiasha M Coakley does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1750809042
Provider Type
Individual
Full Name
Coakley, Tiasha M
Title
Ms.
Credential
RN

Gender
Female
Sole Proprietor
No
Enumeration Date
9/6/2017
Last Updated
7/21/2022

Contact Information

Practice Location

15 James P. Kelly Way, 4, Middletown, NY 10940

Unlisted Fax

Mailing Location

15 James P Kelly Way, 4, Middletown, NY 10940-7199

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 704184 New York