Individual
LAWRENCE COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7979 N SHADELAND AVE STE 310, INDIANAPOLIS, IN 46250-2042
(317) 621-3970
(317) 621-3087
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001955A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000816986
ANTHEM
IN
05
—
200851760
—
IN
Enumeration date
02/08/2007
Last updated
08/10/2023
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