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General NPI Number Information
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NPI Number | 1366486276
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Entity Type | Individual
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Provider Name | AUDREY JOANN COFFMAN LVN
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 58TH & 761ST ST TANK BATTALION AVE THOMAS MOORE HEALTH CLINIC BLDG 2245
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-2621
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Fax | 254-285-6193
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Provider Business Mailing Address
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Address Line | 36000 DARNALL LOOP CARL R DARNALL ARMY MEDICAL CENTER
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-2621
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Fax | 254-285-6193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 181283
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License Number State | TX
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