Healthcare Provider Details

I. General information

NPI: 1689771339
Provider Name (Legal Business Name): JANET ANN COLEMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET LEWIS COLEMAN R.N.

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 BILLINGSLEY RD
CHARLOTTE NC
28211-1003
US

IV. Provider business mailing address

249 BILLINGSLEY RD
CHARLOTTE NC
28211-1003
US

V. Phone/Fax

Practice location:
  • Phone: 704-336-5386
  • Fax: 704-331-0859
Mailing address:
  • Phone: 704-336-5386
  • Fax: 704-331-0859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number073934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: