Provider Demographics
NPI:1306062310
Name:COFFMAN, BRITTANY (PA-C, CPM)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:PA-C, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3376 SUMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-6409
Mailing Address - Country:US
Mailing Address - Phone:443-280-3177
Mailing Address - Fax:410-934-1472
Practice Address - Street 1:3376 SUMANTOWN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:MD
Practice Address - Zip Code:21769-6409
Practice Address - Country:US
Practice Address - Phone:443-280-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03512363AM0700X
MDDEM00019176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC03512OtherMARYLAND LICENSE
MD18040007OtherNARM