Provider Demographics
NPI:1003276197
Name:COFFIA, MICHAELA (NP)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:COFFIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:
Other - Last Name:BAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6227 FRANKFORT HWY
Mailing Address - Street 2:
Mailing Address - City:BENZONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49616-8632
Mailing Address - Country:US
Mailing Address - Phone:231-882-9661
Mailing Address - Fax:231-882-9616
Practice Address - Street 1:826 FOREST AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:MI
Practice Address - Zip Code:49635-9003
Practice Address - Country:US
Practice Address - Phone:231-352-5285
Practice Address - Fax:231-352-6384
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704269943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily