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NPI 1285199802

NPI 1285199802 : STEPHANIE ANN COLEMAN FNP : DYERSBURG, TN

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General NPI Number Information
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    NPI Number           |    1285199802
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHANIE ANN COLEMAN FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/07/2019
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    Last Update Date     |    12/04/2025
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Provider Practice Location Address
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    Address Line         |    1355 FLOWERING DOGWOOD LN 
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    City                 |    DYERSBURG
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    State                |    TN
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    Zip                  |    38024-2893
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    Country              |    US
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    Telephone            |    731-664-4414
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    350 N HUMPHREYS BLVD 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38120-2177
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    Country              |    US
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    Telephone            |    901-226-4003
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    Fax                  |    901-227-8591
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    025427
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    25427
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    License Number State |    TN
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