| NPI | 1861901506 |
|---|---|
| Former Name | AMANDA COFFMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024175400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024175400) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2019-10-22 |