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General NPI Number Information
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NPI Number | 1346892213
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Entity Type | Individual
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Provider Name | LISA COLEMAN NP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 2344 RIVERSIDE DR
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City | DANVILLE
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State | VA
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Zip | 24540-4212
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Country | US
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Telephone | 540-769-3964
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Fax |
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Provider Business Mailing Address
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Address Line | 574 MANGRUMS RD
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City | DANVILLE
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State | VA
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Zip | 24541-8508
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Country | US
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Telephone | 434-228-9571
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | F07190388
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0024178030
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024178030
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024178030
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License Number State | VA
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