MEDICARE: EMILY ALICIA COFFEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	282837	AZ

General Provider Information

NPI Number	:	1871218768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ALICIA COFFEY NP

Provider Business Mailing Address
First Line	:	21681 N 77TH AVE STE 1415
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-2133
Country	:	US
Telephone Number	:	623-572-9200
Fax Number	:	623-572-9204

Provider Business Practice Location Address
First Line	:	21681 N 77TH AVE STE 1415
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-2133
Country	:	US
Telephone Number	:	623-572-9200
Fax Number	:	623-572-9204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	03/17/2026

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