Provider Demographics
NPI:1376643809
Name:COFFIN, ABIGAIL STARBUCK (NP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:STARBUCK
Last Name:COFFIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 BICKLEY PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1301
Mailing Address - Country:US
Mailing Address - Phone:919-923-6085
Mailing Address - Fax:
Practice Address - Street 1:1401 WEST ASH STREET
Practice Address - Street 2:CHERRY HOSPITAL - NC DHHS
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530
Practice Address - Country:US
Practice Address - Phone:919-947-8232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC205888363LP0808X
NC5001441363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113015Medicaid
Q68326Medicare UPIN
NC6113015Medicaid