Healthcare Provider Details

I. General information

NPI: 1831008572
Provider Name (Legal Business Name): NINA JANE COFFEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 S ASH ST
BUFFALO MO
65622-9311
US

IV. Provider business mailing address

465 STONEHAVEN RD
TUNAS MO
65764-9183
US

V. Phone/Fax

Practice location:
  • Phone: 417-345-2222
  • Fax:
Mailing address:
  • Phone: 417-733-2162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: