Healthcare Provider Details

I. General information

NPI: 1477574879
Provider Name (Legal Business Name): ANNE PERRY COLEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 57TH ST
SPRINGFIELD OR
97478-6825
US

IV. Provider business mailing address

1088 57TH ST
SPRINGFIELD OR
97478-6825
US

V. Phone/Fax

Practice location:
  • Phone: 541-746-7995
  • Fax: 541-746-4560
Mailing address:
  • Phone: 541-746-7995
  • Fax: 541-746-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: