Coffee, Carol S.

Coffee, Carol S. is an sole proprietor health care provider with primary practice located at 504 S Vine St , Advance MO 63730-8060. She recently has only one registered license in Nursing Service Providers / Administrator, which is considered as her primary health care specialty. Coffee, Carol S. can be contacted via phone (573) 722-6111.

Contact Information

Primary practice address
504 S Vine St Advance MO 63730-8060
Phone: (573) 722-6111
Fax: (573) 722-6555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Administrator 163WA2000X 2001031601 Missouri

Profile Details

NPI number 1316591340
LBN Legal business name Coffee, Carol S.
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2019
Last updated Jul 29th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316591340 NPPES
Missouri MEDICAID 266135003

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