Provider Demographics
NPI:1659027340
Name:COFFEY, ANDREA (PA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:COFFEY
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Gender:F
Credentials:PA
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Mailing Address - Street 1:11053 VERVE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0984
Mailing Address - Country:US
Mailing Address - Phone:281-753-8968
Mailing Address - Fax:
Practice Address - Street 1:11053 VERVE DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0984
Practice Address - Country:US
Practice Address - Phone:760-242-2146
Practice Address - Fax:760-242-1524
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-12-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant