Provider Demographics
NPI:1780492033
Name:COGGON, EMILY (BSN, RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:COGGON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31505 N SCHNEPF RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-7008
Mailing Address - Country:US
Mailing Address - Phone:520-840-5996
Mailing Address - Fax:
Practice Address - Street 1:31505 N SCHNEPF RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-7008
Practice Address - Country:US
Practice Address - Phone:520-840-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN161350163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse