| Doctor Name: | KRISTEN COBURN |
| NPI Number: | 1437342805 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP/C |
| License Number: | NP-818A |
| Business Practice Address: | 120 E Howard St Driggs, ID - 834225112 |
| Business Phone Number: | 2083542383 |
| Business Fax Number: | |
| Mailing Address: | 391 N 1st E, DRIGGS |
| State: | ID |
| Postal Code: | 834225162 |
| Phone Number: | 2083542475 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2007 |
| NPI Last Update Date: | 08/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-818A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |