Individual
ELIZABETH THERESE COFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12 EAGLE CHASE CT, HENDERSON, NV 89052-6470
(989) 573-0936
Mailing address
12 EAGLE CHASE CT, HENDERSON, NV 89052-6470
(989) 573-0936
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6802089761
MI
363A00000X
Physician Assistant
5601010553
MI
363AM0700X
Medical Physician Assistant
Primary
PA2844
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2844
PHYSICIAN ASSISTANT LICENSE
NV
05
—
PA2844
—
NV
Enumeration date
10/17/2017
Last updated
11/14/2024
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