Teresa Coffman, LPN
Licensed Practical Nurse in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1790233302
StatusActive
Last updated in NPPESSep 13, 2016
Details
- NPI
- 1790233302
- Entity type
- Individual (NPI-1)
- Name
- Teresa Coffman
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 13, 2016
- Last updated
- Sep 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 4703065143 | MI | Yes |
Practice location
3492 Lake Dr SeGrand Rapids, MI 49546-4338
Phone 616-957-4057
Mailing address
3492 Lake Dr SeGrand Rapids, MI 49546-4338
Phone 616-957-4057
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