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LEAH MARIE COFFMAN PAUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
191464
TN
163W00000X
Registered Nurse
777690
CA
367500000X
Certified Registered Nurse Anesthetist
17352
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1509
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013269307
CHAMPUS/TRICARE
TN
05
12528316
TN
05
196811001
AR
01
4342775
BLUE CROSS TN
TN
Enumeration date
10/10/2012
Last updated
09/11/2020
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