Provider Demographics
NPI:1265005532
Name:COFFRAN, KELSEY FERRARA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:FERRARA
Last Name:COFFRAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:BETTEZ
Other - Last Name:FERRARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:21 SHARON DRIVE
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816
Mailing Address - Country:US
Mailing Address - Phone:401-626-5342
Mailing Address - Fax:
Practice Address - Street 1:12596 W BAYAUD AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228
Practice Address - Country:US
Practice Address - Phone:303-468-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997597-NP364SF0001X
MARN2331744163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice