Individual
JENNIFER C COFFARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
740 S LIMESTONE, KENTUCKY CLINIC 4TH FLOOR, WING D, LEXINGTON, KY 40536-0001
(859) 323-5643
Mailing address
740 S LIMESTONE, 4TH FLOOR WING D, LEXINGTON, KY 40536-0284
(859) 323-5643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1661
KY
363AM0700X
Medical Physician Assistant
PA1661
KY
363AS0400X
Surgical Physician Assistant
PA1661
KY
Other
Enumeration date
09/26/2011
Last updated
08/17/2020
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