Provider Demographics
NPI:1952990194
Name:COFFEY, MEHGAN NOEL (NP)
Entity Type:Individual
Prefix:
First Name:MEHGAN
Middle Name:NOEL
Last Name:COFFEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15803 SCREAMING EAGLE AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-5290
Mailing Address - Country:US
Mailing Address - Phone:661-201-2040
Mailing Address - Fax:
Practice Address - Street 1:1111 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1936
Practice Address - Country:US
Practice Address - Phone:661-326-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily