Individual
MISS DEIDRE A COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1122 S IRONWOOD DR, SOUTH BEND, IN 46615-1618
(574) 335-8399
(574) 335-0786
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-8399
(574) 335-0786
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28133609A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201025560
—
IN
Enumeration date
06/12/2011
Last updated
01/12/2026
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