Provider Demographics
NPI:1073128989
Name:COLEMAN, ABIGAIL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21835 VENTURA BLVD STE 21837
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1838
Mailing Address - Country:US
Mailing Address - Phone:818-600-7348
Mailing Address - Fax:
Practice Address - Street 1:21835 VENTURA BLVD STE 21837
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1838
Practice Address - Country:US
Practice Address - Phone:818-600-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA734773163W00000X
CA95015457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse