Provider Demographics
NPI:1871522615
Name:COFFEY, STEPHEN E (ARNP)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:COFFEY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREAT FALLS PLZ
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-5966
Mailing Address - Country:US
Mailing Address - Phone:207-782-4022
Mailing Address - Fax:207-784-3537
Practice Address - Street 1:2 GREAT FALLS PLZ
Practice Address - Street 2:3RD FLOOR
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5966
Practice Address - Country:US
Practice Address - Phone:207-782-4022
Practice Address - Fax:207-784-3537
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH046392-23-05363LA2200X
MECNP151098363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1871522615Medicaid
NH30340590Medicaid
NHNP196601Medicare PIN
S87373Medicare UPIN
ME1871522615Medicaid
NH30340590Medicaid