Healthcare Provider Details

I. General information

NPI: 1487248795
Provider Name (Legal Business Name): JASMINE COFIELD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W BIG BEAVER RD STE 200
TROY MI
48084-5283
US

IV. Provider business mailing address

112 W YORK AVE
FLINT MI
48505-2028
US

V. Phone/Fax

Practice location:
  • Phone: 734-274-9404
  • Fax: 734-822-0075
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601010452
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: