Provider Demographics
NPI:1306398607
Name:COFFMAN, AMBER (NP-C, CMSRN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:NP-C, CMSRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 N HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6902
Mailing Address - Country:US
Mailing Address - Phone:813-248-2700
Mailing Address - Fax:813-248-2722
Practice Address - Street 1:5101 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-248-2700
Practice Address - Fax:813-248-2722
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP09312010364SA2200X, 363L00000X
FLAPRN09312010363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner