Healthcare Provider Details

I. General information

NPI: 1134046121
Provider Name (Legal Business Name): GMG STAAFLY PRODUCTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 BAYWOOD DR APT 204
CORONA CA
92881-3333
US

IV. Provider business mailing address

1800 BAYWOOD DR APT 204
CORONA CA
92881-3333
US

V. Phone/Fax

Practice location:
  • Phone: 702-712-3591
  • Fax:
Mailing address:
  • Phone: 702-712-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MS. NICHELLE SHENITA COLEMAN
Title or Position: OWNER
Credential: WELLNESS COACH
Phone: 702-712-3591