Provider Demographics
NPI:1578258422
Name:COACH, KARA NICOLE
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:NICOLE
Last Name:COACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 3RD ST UNIT 186
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-7710
Mailing Address - Country:US
Mailing Address - Phone:803-479-9824
Mailing Address - Fax:
Practice Address - Street 1:2740 3RD ST UNIT 186
Practice Address - Street 2:2740 3RD ST UNIT 186
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183
Practice Address - Country:US
Practice Address - Phone:803-479-9824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula