Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9269008 | FL |
NPI | 1003270448 |
---|---|
Provider Name | Kerrie Michelle Coffman |
First Address | Clearwater, FL 33756-3354 |
Second Address | Clearwater, FL 33756-3354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 25/01/2017 |