Provider Demographics
NPI:1902229115
Name:COFFEY, LINDA (CNM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9275 SW 152ND ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1701
Mailing Address - Country:US
Mailing Address - Phone:305-238-7873
Mailing Address - Fax:
Practice Address - Street 1:927 45TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-209-6990
Practice Address - Fax:561-209-5419
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001155043163W00000X
FL9407308176B00000X, 363LX0001X, 367A00000X
VA0024000021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology