Provider Demographics
NPI:1093314890
Name:COLEMAN, EMORY (CRNP)
Entity Type:Individual
Prefix:
First Name:EMORY
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WHITESPORT DR SW STE 201
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6429
Mailing Address - Country:US
Mailing Address - Phone:256-489-3836
Mailing Address - Fax:256-489-3940
Practice Address - Street 1:400 WHITESPORT DR SW STE 201
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6429
Practice Address - Country:US
Practice Address - Phone:256-489-3836
Practice Address - Fax:256-489-3940
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-156230363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care