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General NPI Number Information
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NPI Number | 1740157940
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Entity Type | Individual
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Provider Name | ELISHA J COLEMAN LSA
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Gender | Female
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 10004 CHESTER RD
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City | CHESTER
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State | VA
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Zip | 23831-1110
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Country | US
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Telephone | 804-586-8389
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Fax |
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Provider Business Mailing Address
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Address Line | 7806 SILVER MIST AVE
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23237-1976
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Country | US
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Telephone | 804-586-8689
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 0136000080
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License Number State | VA
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