Individual
JEFFREY KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
(574) 537-2652
Mailing address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
28107948A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000660A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000532950
ANTHEM PIN
—
05
—
200233490
—
IN
01
—
500030615
RAILROAD MEDICARE PIN
IN
Enumeration date
07/07/2006
Last updated
08/24/2011
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