Provider Demographics
NPI:1831354455
Name:COFER, DAVID STEPHEN (NP-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:STEPHEN
Last Name:COFER
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MCBRIEN RD APT A5
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-4829
Mailing Address - Country:US
Mailing Address - Phone:423-618-7192
Mailing Address - Fax:
Practice Address - Street 1:216 THACKER DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRING
Practice Address - State:GA
Practice Address - Zip Code:30739-7200
Practice Address - Country:US
Practice Address - Phone:706-764-1239
Practice Address - Fax:312-268-6115
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13528363LF0000X
GARN166860363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily