LANIE BLAIR COFFEY (NPI# 1760793020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760793020 |
| Entity Type | Individual |
| Full Name | LANIE BLAIR COFFEY |
| Credential | RDLD |
| Practice Address |
1300 W Lancaster Ave Ste 204 Fort Worth TX 76102-3490 |
| Mailing Address |
Po Box 99371 Fort Worth TX 76199-0371 |
| Practice Telephone | 6828852170 |
| Practice Fax Number | 8173358277 |
| Mailing Telephone | 6828851855 |
| Mailing Fax Number | 6828857347 |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2016-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | DT81561 | TX | Dietary & Nutritional Service Providers |
| Y | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
DT81561 | TX | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 212716901 | 05 | |
| TX | BCBS | 8CL226 | 01 |
| Street Address |
1300 W LANCASTER AVE STE 204 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76102-3490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184651077 | Joanne Nguyen | Medical Genetics | 1300 W Lancaster Ave Ste 204, Fort Worth, TX 76102-3490 | 2006-06-27 |
| 1235518747 | Sara Kathleen Preisendanz | Dietitian, Registered | 1300 W Lancaster Ave Ste 204, Fort Worth, TX 76102-3490 | 2015-05-29 |
| 1457648917 | Alexandra Garza Flores | Medical Genetics | 1300 W Lancaster Ave Ste 204, Fort Worth, TX 76102-3490 | 2011-07-06 |
| 1467689034 | Heather P Crawford | Medical Genetics | 1300 W Lancaster Ave Ste 204, Fort Worth, TX 76102-3490 | 2009-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113746 | Deirdre P Browne | Counselor | 1500 E El Paso, Fort Worth, TX 76102 | 2018-08-07 |
| 1740784206 | Cvs Pharmacy Inc | Pharmacy | 515 Houston St, Fort Worth, TX 76102 | 2018-03-20 |
| 1316448061 | Diondra Deshawn Narcisse | Licensed Vocational Nurse | 1314 Lake Street, Fort Worth, TX 76102 | 2018-02-27 |
| 1649779943 | Carmela A Solis | Specialist/Technologist, Other | 500 Throckmorton Street Unit 3309, Fort Worth, TX 76102 | 2018-02-02 |
| 1104324516 | Vicki Webb-baker | Health Educator | 512 Lamar Street, Suite 400, Fort Worth, TX 76102 | 2018-01-31 |
| 1235647678 | Brianna Marie Keister | Occupational Therapist | 201 W. Lancaster Ave, 417, Fort Worth, TX 76102 | 2018-01-19 |
| 1437507910 | Medical Hearing Services, LLC | Hearing Aid Equipment | 1201 Summit Avenue, Fort Worth, TX 76102 | 2016-05-25 |
| 1891171476 | Karis Starke | Physical Therapy Assistant | 2500 West Freeway (i-30), 100, Fort Worth, TX 76102 | 2015-08-05 |
| 1265839344 | Fm Katy Dental and Orthodontics, Pllc | Dentist | 100 E 15th Ste 520, Fort Worth, TX 76102 | 2014-12-04 |
| 1093134512 | Superior Evaluation Services | General Practice | 420 Throckmorton Suite 200, Ft. Worth, TX 76102 | 2014-04-11 |
| Find all providers in zip 76102 | ||||
| Taxonomy Code | 133VN1004X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Pediatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696493 | Leekelli Kennedy | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2020-10-15 |
| 1497389126 | Chelsea Barrow | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2020-03-03 |
| 1689217432 | Claire Koskie | Dietitian, Registered | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-10-24 |
| 1972153112 | Alexis Courtney | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-09-19 |
| 1366099376 | Haley Tullos | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-08-23 |
| 1538716139 | Amanda Rae Macdonald | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-08-20 |
| 1730731498 | Erin Walkley | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-07-12 |
| 1336701986 | Adyson Lacy Mitchell | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-07-03 |
| 1588122519 | Katherine Yost | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-03-08 |
| 1467920876 | Courtney Nordhus | Dietitian, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2018-11-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76102 |
Please comment or provide details below to improve the information on LANIE BLAIR COFFEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.