Provider Demographics
NPI:1689459406
Name:COFFEY, ANGELA NICOLE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:COFFEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 CHILHOWEE ST
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2203
Mailing Address - Country:US
Mailing Address - Phone:865-224-4397
Mailing Address - Fax:
Practice Address - Street 1:934 CHILHOWEE ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2203
Practice Address - Country:US
Practice Address - Phone:865-224-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker