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General NPI Number Information
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NPI Number | 1104499805
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Entity Type | Individual
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Provider Name | CAROLYN COLEMAN NP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 2500 E PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-9718
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Country | US
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Telephone | 970-493-0112
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Fax | 970-493-0521
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Provider Business Mailing Address
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Address Line | 2500 E PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-9718
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Country | US
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Telephone | 970-493-0112
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Fax | 970-493-0521
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0999601-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 1631510
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License Number State | CO
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