Individual
MR. RANDALL LEE COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
10905 PROVIDENCE RD W, SUITE G200, CHARLOTTE, NC 28277-1538
(980) 488-4900
(980) 488-4905
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(980) 488-4900
(980) 488-4905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5013564
NC
363LA2100X
Acute Care Nurse Practitioner
5013564
NC
Other
Enumeration date
08/25/2020
Last updated
05/22/2023
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