Provider Demographics
NPI:1033990262
Name:COFFMAN, ALLISON ANNETTE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ANNETTE
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14860 FLOYD LN
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2273
Mailing Address - Country:US
Mailing Address - Phone:913-957-8278
Mailing Address - Fax:
Practice Address - Street 1:12290 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4049
Practice Address - Country:US
Practice Address - Phone:913-327-1332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist