Individual
NICOLE COFTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
W68N611 EVERGREEN BLVD, CEDARBURG, WI 53012-1847
(262) 376-6149
Mailing address
W68N611 EVERGREEN BLVD, CEDARBURG, WI 53012-1847
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
125512
WI
Other
Enumeration date
05/29/2026
Last updated
05/29/2026
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