# AMY ELIZABETH COBURN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871729277
- **Gender:** F
- **Credential:** O.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1574-607T | LA | Yes |

## Other

- **Enumeration date:** 06/01/2009
- **Last updated:** 12/11/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 185546722 | — | AR |
| 05 | — | 1888982 | — | LA |