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General NPI Number Information
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NPI Number | 1518904135
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Entity Type | Individual
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Provider Name | KATHERINE SILLIMAN COFFEY PA
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Gender | Female
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1295 WILSON HALL RD
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City | SUMTER
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State | SC
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Zip | 29150-1804
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Country | US
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Telephone | 803-905-6800
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Fax | 803-905-6810
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Provider Business Mailing Address
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Address Line | 8 S BROOKS ST
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City | MANNING
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State | SC
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Zip | 29102-3110
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Country | US
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Telephone | 864-706-0543
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1071
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License Number State | SC
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