Lindsay Coffman

Individual provider Active NPI Family Nurse Practitioner · Ardmore, PA

NPI 1194120832 · NPPES record last updated Dec 30, 2015

Key facts

NPI
1194120832
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
SP014383 (PA)
Practice address
610 West Lancaster Avenue
Ardmore, PA 19003
Phone
(610) 111-1111
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP014383PAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014383 PA Yes

Addresses

Primary practice location

610 West Lancaster Avenue
Ardmore, PA 19003

Mailing address

169 W Lancaster Ave
Ardmore, PA 19003-1401

Other providers in Ardmore, PA

All providers in Ardmore, PA · Family Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.