Individual
MICHAEL COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3662 W INA RD STE 150, TUCSON, AZ 85741-2269
(520) 912-4242
Mailing address
2084 E 6425 S, HOLLADAY, UT 84121-2208
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9022501-4405
UT
363L00000X
Nurse Practitioner
95010198
CA
363LF0000X
Family Nurse Practitioner
Primary
219518
AZ
Other
Enumeration date
11/13/2018
Last updated
11/23/2018
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