Individual
SARA COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28160949A
IN
363L00000X
Nurse Practitioner
Primary
71013113A
IN
Other
Enumeration date
09/26/2022
Last updated
03/23/2023
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