Provider Demographics
NPI:1376502641
Name:COIRIER, CAROL ANN (PA)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:COIRIER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:600 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL GROVE
Mailing Address - State:KS
Mailing Address - Zip Code:66846-1422
Mailing Address - Country:US
Mailing Address - Phone:620-273-6131
Mailing Address - Fax:620-273-6133
Practice Address - Street 1:411 WALNUT
Practice Address - Street 2:
Practice Address - City:COTTONWOOD FALLS
Practice Address - State:KS
Practice Address - Zip Code:66845
Practice Address - Country:US
Practice Address - Phone:620-273-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500198363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS042096OtherBLUE CROSS BLUE SHIELD