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General NPI Number Information
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NPI Number | 1548587082
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Entity Type | Individual
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Provider Name | DANIEL VICTOR COLEMAN LPN
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Gender | Male
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 806 N 4TH ST
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City | GREENFIELD
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State | OH
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Zip | 45123-1012
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Country | US
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Telephone | 937-981-0656
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Fax |
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Provider Business Mailing Address
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Address Line | 806 N 4TH ST
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City | GREENFIELD
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State | OH
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Zip | 45123-1012
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Country | US
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Telephone | 937-981-0656
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN037569
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | PN037569
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | PN037569
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License Number State | OH
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