Healthcare Provider Details

I. General information

NPI: 1861202566
Provider Name (Legal Business Name): ELIZABETH LEIGH COFFMAN MSN FNP-C, RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH LEIGH SINGLETON

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MICHIGAN ST NE
GRAND RAPIDS MI
49503-2560
US

IV. Provider business mailing address

11550 BOYNE BLVD
ALLENDALE MI
49401-9554
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-1774
  • Fax:
Mailing address:
  • Phone: 616-893-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704304414
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: