Provider Demographics
NPI:1669225207
Name:COGGINS, CHANTEL
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:COGGINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 5 MILE RD
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:MI
Mailing Address - Zip Code:48628-9738
Mailing Address - Country:US
Mailing Address - Phone:989-513-7213
Mailing Address - Fax:
Practice Address - Street 1:6408 5 MILE RD
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:MI
Practice Address - Zip Code:48628-9738
Practice Address - Country:US
Practice Address - Phone:989-513-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula