Healthcare Provider Details

I. General information

NPI: 1245170810
Provider Name (Legal Business Name): VIOLET COFFY MSN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 TWILIGHT LN
MONROE NC
28110-6109
US

IV. Provider business mailing address

3018 TWILIGHT LN
MONROE NC
28110-6109
US

V. Phone/Fax

Practice location:
  • Phone: 704-635-4994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025091774
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: