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General NPI Number Information
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NPI Number | 1144737339
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Entity Type | Individual
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Provider Name | JENNIFER MARIE COLEMAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 1850 N CENTRAL AVE STE 1600
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City | PHOENIX
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State | AZ
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Zip | 85004-4633
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Country | US
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Telephone | 602-262-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 E BASELINE RD UNIT 153
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City | PHOENIX
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State | AZ
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Zip | 85042-6380
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Country | US
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Telephone | 520-709-0050
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA1461
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License Number State | AZ
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