MEDICARE: WILLIAM KEVIN COLEMAN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	245462	LA

General Provider Information

NPI Number	:	1104774025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM KEVIN COLEMAN FNP-C

Provider Business Mailing Address
First Line	:	611 GRAMMONT ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-7565
Country	:	US
Telephone Number	:	318-325-2634
Fax Number	:	318-325-0717

Provider Business Practice Location Address
First Line	:	611 GRAMMONT ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-7565
Country	:	US
Telephone Number	:	318-325-2634
Fax Number	:	318-325-0717

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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