Healthcare Provider Details

I. General information

NPI: 1629972773
Provider Name (Legal Business Name): KATHERINE JANETTE COFER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W FRANCISCAN DR
CROWN POINT IN
46307-4802
US

IV. Provider business mailing address

12404 KINGFISHER RD
CROWN POINT IN
46307-8465
US

V. Phone/Fax

Practice location:
  • Phone: 219-661-5100
  • Fax:
Mailing address:
  • Phone: 219-661-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28113682A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: