MEDICARE: BRITTANY COLEMAN RN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4704360696	MI

General Provider Information

NPI Number	:	1730990623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY COLEMAN RN

Provider Business Mailing Address
First Line	:	39600 GARFIELD RD STE F
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39600 GARFIELD RD STE F
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5913
Country	:	US
Telephone Number	:	734-600-7873
Fax Number	:

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

Provider Enumeration Date	:	01/18/2025
Last Update Date	:	10/15/2025

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