Provider Demographics
NPI:1952332454
Name:COEN, DARIN P (PA-C)
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:P
Last Name:COEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 RING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7998
Mailing Address - Country:US
Mailing Address - Phone:270-737-2273
Mailing Address - Fax:
Practice Address - Street 1:2412 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7998
Practice Address - Country:US
Practice Address - Phone:270-737-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
11524668OtherCAQH
11524668OtherCAQH
Q56339Medicare UPIN