Active NPI
Patricia Ann Coburn, FNP-BC
- Family Nurse Practitioner
- Fort Lee, VA
National Provider Identifier
1073655155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 13-67659-101
- Practice address
- 700 24TH St
Kenner Army Health Clinic
Fort Lee, VA 23801-1716 - Phone
- (804) 734-9942
- Fax
- (877) 874-1008
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13-67659-101 | KS | Primary |
Addresses
Primary practice location
700 24TH St
Kenner Army Health Clinic
Fort Lee, VA 23801-1716
Mailing address
700 24TH St
Kenner Army Health Clinic
Fort Lee, VA 23801-1716
Phone (804) 734-9942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13-67659-101 | KS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1073655155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 24TH ST",
"address_2": "KENNER ARMY HEALTH CLINIC",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9942",
"fax_number": "877-874-1008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 24TH ST",
"address_2": "KENNER ARMY HEALTH CLINIC",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9942",
"fax_number": "877-874-1008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBURN",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KS",
"license": "13-67659-101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.