MEDICARE: MS. HANNAH MARY ELIZABETH COLEMAN PA-C

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	363A00000X	Physician Assistant	PA9111624	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508340183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH MARY ELIZABETH COLEMAN PA-C

Provider Business Mailing Address
First Line	:	2337 SW ARCHER RD APT 1009
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1008
Country	:	US
Telephone Number	:	757-506-5113
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1134
Country	:	US
Telephone Number	:	352-594-7555
Fax Number	:

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

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	09/20/2018

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Directions to “ MS. HANNAH MARY ELIZABETH COLEMAN PA-C” Practice Location

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