Provider Demographics
NPI:1629373055
Name:COGGINS-POWELL, KAREN SUE (AA,BA,MS,CNA,)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:COGGINS-POWELL
Suffix:
Gender:F
Credentials:AA,BA,MS,CNA,
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:COGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA,BA,MS,CNA,
Mailing Address - Street 1:11428 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2216
Mailing Address - Country:US
Mailing Address - Phone:813-374-9416
Mailing Address - Fax:813-443-5795
Practice Address - Street 1:11428 N 53RD ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-2216
Practice Address - Country:US
Practice Address - Phone:813-374-9416
Practice Address - Fax:813-443-5795
Is Sole Proprietor?:No
Enumeration Date:2011-01-15
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100668376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide