Provider Demographics
NPI:1336923465
Name:COGGINS, ELIZABETH JANE (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:COGGINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:MEETEETSE
Mailing Address - State:WY
Mailing Address - Zip Code:82433-0341
Mailing Address - Country:US
Mailing Address - Phone:307-250-7817
Mailing Address - Fax:
Practice Address - Street 1:1315 DUTCH RD
Practice Address - Street 2:
Practice Address - City:MEETEETSE
Practice Address - State:WY
Practice Address - Zip Code:82433-5058
Practice Address - Country:US
Practice Address - Phone:307-250-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY40081163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn