Individual
ANGELA COFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-FNP-C
Contact information
Practice address
1221 N MAIN ST, BEAVER DAM, KY 42320-8955
(270) 775-6060
(270) 339-7791
Mailing address
1221 N MAIN ST, BEAVER DAM, KY 42320-8955
(270) 775-6060
(270) 775-6010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3015137
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3015137
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001446476
ANTHEM PIN
—
01
—
12078066
PRIME HEALTH SERVICES PROVIDER ID NUMBER
—
05
—
300044645
—
IN
05
—
7100703790
—
KY
01
—
7557009
UNITED HEALTHCARE PROVIDER ID NUMBER
—
01
—
CS2035300109
CARESOURCE PROVIDER ID NUMBER
—
Enumeration date
09/18/2020
Last updated
01/11/2026
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