Provider Demographics
NPI:1861283764
Name:COFFMAN, KRISTA K (LPN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:K
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 NICKIE LN
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-3361
Mailing Address - Country:US
Mailing Address - Phone:419-619-0813
Mailing Address - Fax:
Practice Address - Street 1:1720 E MELROSE AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4413
Practice Address - Country:US
Practice Address - Phone:567-250-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111701164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse