Healthcare Provider Details

I. General information

NPI: 1912024431
Provider Name (Legal Business Name): CINDY L COLEMAN RN, MS, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 PARK STREET
ALFRED NY
14802
US

IV. Provider business mailing address

874 KARR VALLEY RD
ALMOND NY
14804-9741
US

V. Phone/Fax

Practice location:
  • Phone: 607-871-2400
  • Fax: 607-871-2631
Mailing address:
  • Phone: 607-276-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332755-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: