Healthcare Provider Details

I. General information

NPI: 1154844363
Provider Name (Legal Business Name): RAYONDA ANTRICE MOON COLEMAN DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAYONDA COLEMAN CRNA

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HOSPITAL DR
MACON GA
31217-3838
US

IV. Provider business mailing address

350 HOSPITAL DR
MACON GA
31217-3838
US

V. Phone/Fax

Practice location:
  • Phone: 478-765-7000
  • Fax:
Mailing address:
  • Phone: 478-765-7000
  • Fax: 478-310-3112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209028997
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number208582
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN270737
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number769340
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: