| Doctor Name: | MISS DEIDRE A COFFEY |
| NPI Number: | 1467747014 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 28133609A |
| Business Practice Address: | 1120 W South St Bremen, IN - 465061849 |
| Business Phone Number: | 5745461251 |
| Business Fax Number: | 5743350760 |
| Mailing Address: | Po Box 6309, SOUTH BEND |
| State: | IN |
| Postal Code: | 466606309 |
| Phone Number: | 5744726700 |
| Fax Number: | 5743350760 |
| NPI Enumeration Date: | 06/12/2011 |
| NPI Last Update Date: | 02/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 28133609A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |