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NPI Code Detail

MEDICARE: MS. ANITA KYM COLEMAN

MEDICARE:  MS. ANITA KYM COLEMAN
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
1164W00000XLicensed Practical Nurse34722-31WI

General Provider Information

NPI Number : 1952659633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANITA KYM COLEMAN
Provider Business Mailing Address
First Line : 4909 N 66TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-4035
Country : US
Telephone Number : 414-350-2671
Fax Number :
Provider Business Practice Location Address
First Line : 4909 N 66TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-4035
Country : US
Telephone Number : 414-350-2671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2012
Last Update Date : 08/28/2012

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Directions to “ MS. ANITA KYM COLEMAN ” Practice Location

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