Bonnie Jean Coburn is a Family in Decatur, Illinois. Bonnie Jean Coburn practices all healthcare services and medical treatments related to Family. The NPI Number for Bonnie Jean Coburn is 1720165103. The last update date is 2023-12-06.
Bonnie Jean Coburn's current location address is 2300 N Edward St Ste 6102, Decatur, Illinois. You can contact this provider via phone number 2178766456 and fax number 2178766485. The mailing address for Bonnie Jean Coburn is 2300 N Edward St Ste 6102, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bonnie Jean Coburn |
|---|---|
| Address | 2300 N Edward St Ste 6102, Decatur, Illinois |
| Phone Number | 2178766456 |
| Fax Number | 2178766485 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1720165103 |
|---|---|
| Provider Enumeration Date | 2006-11-01 |
| Last Updated Date | 2023-12-06 |
Provider Mailing Address Detail
| Address | 2300 N Edward St Ste 6102 |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625264163 |
| Phone Number | 2178766456 |
| Fax Number | 2178766485 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 277000529 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 41292879 | IL | -- | |
| 036102377 1 | IL | -- | |
| 433990 | IL | MEDICARE GROUP | |
| 1497762959 1 | IL | -- | |
| P00678744 | IL | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Bonnie Jean Coburn by the Centers for Medicare & Medicaid Services?
The Bonnie Jean Coburn has been assigned the NPI (National Provider Identifier) 1720165103 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Bonnie Jean Coburn?
The Bonnie Jean Coburn is physically situated at 2300 N Edward St Ste 6102, in the city of Decatur, state of IL, with the postal code 625264163.
What is Bonnie Jean Coburn's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Bonnie Jean Coburn is Family, and the taxonomy classification code that categorizes this area of expertise is 363Lf0000X.
On what date did Bonnie Jean Coburn receive its 1720165103 assignment from the Centers for Medicare & Medicaid Services?
The Bonnie Jean Coburn was assigned its 1720165103 on 2006-11-01, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Bonnie Jean Coburn, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Bonnie Jean Coburn, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2023-12-06.
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