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NPI Code Detail

MEDICARE: MRS. KATHERINE MARIE COLEMAN APRN, FNP-BC

MEDICARE: MRS. KATHERINE MARIE COLEMAN APRN, FNP-BC
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
1363LF0000XFamily Nurse Practitioner20047SC

Other Identifiers

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

General Provider Information

NPI Number : 1659732667
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE MARIE COLEMAN APRN, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 23321
Second Line :
City : NEW YORK
State : NY
Zip : 10087-4321
Country : US
Telephone Number : 803-296-7320
Fax Number : 803-296-7320
Provider Business Practice Location Address
First Line : 2435 FOREST DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2026
Country : US
Telephone Number : 803-256-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2016
Last Update Date : 03/02/2026

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