Provider Demographics
NPI:1316262579
Name:COBURN, ALLISON INGA BURI (CNM)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:INGA BURI
Last Name:COBURN
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:993 JOHNSON FERRY ROAD NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1601
Mailing Address - Country:US
Mailing Address - Phone:404-250-1350
Mailing Address - Fax:404-250-1359
Practice Address - Street 1:993 JOHNSON FERRY RD NE # D
Practice Address - Street 2:SUITE 360
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-250-1350
Practice Address - Fax:404-250-1359
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN198926367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife