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General NPI Number Information
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NPI Number | 1659644326
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Entity Type | Individual
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Provider Name | MARY KATHLEEN COLEMAN MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 2202 S PARK ST
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City | MADISON
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State | WI
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Zip | 53713-1916
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Country | US
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Telephone | 608-443-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.009432
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95002356
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP 60265341
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License Number State | WA
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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 | 8750-33
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License Number State | WI
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