Provider Demographics
NPI:1407564792
Name:COFFEY, KARA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:COFFEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10197 TALLADEGA CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-5502
Mailing Address - Country:US
Mailing Address - Phone:317-753-3522
Mailing Address - Fax:
Practice Address - Street 1:550 UNIVERSITY BLVD # UH1501
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-948-1310
Practice Address - Fax:317-948-0503
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2024-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10003824A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant