Individual
ELIZABETH COBLENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2750 BATTLEFIELD MEMORIAL HWY, BEREA, KY 40403-8332
(859) 986-0302
(859) 986-0315
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1112063
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100273450
—
KY
Enumeration date
11/07/2013
Last updated
07/11/2019
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