Individual
LARRY J COFFMAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
425 W WILSHIRE BLVD, OKLAHOMA CITY, OK 73116-7793
(405) 840-2180
(405) 456-6900
Mailing address
916 NE 49TH ST, OKLAHOMA CITY, OK 73105-6801
(405) 706-4988
(405) 456-6900
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
26797
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37-7697
CMS
—
Enumeration date
09/03/2013
Last updated
12/16/2024
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