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Individual
LAWRENCE COFFMAN
Active
Individual
LAWRENCE COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001955A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000816986
ANTHEM
IN
05
—
200851760
—
IN
Enumeration date
02/08/2007
Last updated
08/10/2023
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