Provider Demographics
NPI:1073846788
Name:COLEMAN, JOSEPH SHAWN (LPN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SHAWN
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 POSSUM HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9315
Mailing Address - Country:US
Mailing Address - Phone:740-887-3010
Mailing Address - Fax:
Practice Address - Street 1:793 POSSUM HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9315
Practice Address - Country:US
Practice Address - Phone:740-887-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-13
Last Update Date:2009-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-130 637-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse