Individual
MRS. KATHRYN COKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 836-1542
Mailing address
233 S WHITE ST, MACOMB, IL 61455-3111
(314) 265-9275
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005732
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085005732
STATE LICENSE NUMBER
IL
Enumeration date
11/16/2015
Last updated
12/10/2018
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