Provider Demographics
NPI:1881025039
Name:LUPLOW, COALINE
Entity Type:Individual
Prefix:
First Name:COALINE
Middle Name:
Last Name:LUPLOW
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 1:1132 CHEESMAN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MI
Mailing Address - Zip Code:48880-9402
Mailing Address - Country:US
Mailing Address - Phone:989-763-1016
Mailing Address - Fax:
Practice Address - Street 1:209 E CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1609
Practice Address - Country:US
Practice Address - Phone:989-772-1261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703085412164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse