Provider Demographics
NPI:1194498485
Name:COFFMAN, ELIZABETH ARIANNE (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ARIANNE
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ARIANNE
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17933 E BATES AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2191
Mailing Address - Country:US
Mailing Address - Phone:970-443-2789
Mailing Address - Fax:
Practice Address - Street 1:1683 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-7921
Practice Address - Country:US
Practice Address - Phone:970-686-0124
Practice Address - Fax:970-686-0845
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006918363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant