Blake Coffman, RN is a
Nurse Practitioner physician based in Jackson, Tennessee. Blake Coffman is licensed to practice in Tennessee (license number 35606) and his current practice location is 64 Palmer Dr, Jackson, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(731) 614-0728.
NPI number for Blake Coffman is 1578262192 and his current mailing address is 64 Palmer Dr, Jackson, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1578262192.
Physician's Profile
| Full Name | Blake Coffman |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner |
|---|
| Location | 64 Palmer Dr, Jackson, Tennessee |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1578262192
- Provider Enumeration Date: 03/02/2023
- Last Update Date: 06/17/2024
Medical Identifiers
Medical identifiers for Blake Coffman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578262192 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 35606 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | 35606 (Tennessee) | Secondary |
| 207R00000X | Internal Medicine | 35606 (Tennessee) | Secondary |
| 208000000X | Pediatrics | 35606 (Tennessee) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 35606 (Tennessee) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 35606 (Tennessee) | Secondary |
| 208600000X | Surgery | 35606 (Tennessee) | Secondary |
| 363L00000X | Nurse Practitioner | 35606 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Coffman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Blake Coffman, RN
64 Palmer Dr,
Jackson, TN 38305-8029
Ph: (731) 614-0728 | Blake Coffman, RN
64 Palmer Dr,
Jackson, TN 38305-8029
Ph: (731) 614-0728 |
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