| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CANEISHA DANIELLE COBURN | 1467079236 | 2020-06-28 |
Caneisha Danielle Coburn is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1467079236. Registration indicates Caneisha Danielle Coburn is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Caneisha Danielle Coburn |
| Practice Office Address | 1234 NAPIER AVE SAINT JOSEPH, MI US |
| Practice Office Telephone | 2699838300 |
| Mailing Address | 1234 NAPIER AVE SAINT JOSEPH, MI 490852112 US |
| Business Telephone | 2699838300 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |