Provider Demographics
NPI:1700407103
Name:COFIELD, SADONNA MARLENE
Entity Type:Individual
Prefix:MRS
First Name:SADONNA
Middle Name:MARLENE
Last Name:COFIELD
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 1:1011 ROCK QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3825
Mailing Address - Country:US
Mailing Address - Phone:919-833-3111
Mailing Address - Fax:
Practice Address - Street 1:154 SW MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5715
Practice Address - Country:US
Practice Address - Phone:252-373-0229
Practice Address - Fax:252-937-3021
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF04200157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily