Provider Demographics
NPI:1992022610
Name:COBURN, CAROLINE VARNER (MS, RN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:VARNER
Last Name:COBURN
Suffix:
Gender:F
Credentials:MS, RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:1828 CEDAR CANYON DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-4024
Mailing Address - Country:US
Mailing Address - Phone:404-320-9120
Mailing Address - Fax:
Practice Address - Street 1:1520 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4207
Practice Address - Country:US
Practice Address - Phone:404-727-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN038961NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health