MEDICARE: MARION CATRICE COLEMAN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN230050	GA

General Provider Information

NPI Number	:	1235687906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARION CATRICE COLEMAN FNP

Provider Business Mailing Address
First Line	:	3495 PIEDMONT RD NE
Second Line	:	NINE PIEDMONT CENTER
City	:	ATLANTA
State	:	GA
Zip	:	30305-1717
Country	:	US
Telephone Number	:	404-504-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	1745 PEACHTREE ST NE
Second Line	:	KAISER PERMANENTE BROOKWOOD MEDICAL CENTER
City	:	ATLANTA
State	:	GA
Zip	:	30309-2410
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	01/24/2022

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