Provider Demographics
NPI:1164064101
Name:COLEMAN, CASSIE RENEE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:RENEE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 ISLAND CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-7133
Mailing Address - Country:US
Mailing Address - Phone:606-432-2877
Mailing Address - Fax:
Practice Address - Street 1:238 CASSIDY BLVD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1426
Practice Address - Country:US
Practice Address - Phone:606-430-2230
Practice Address - Fax:606-437-2526
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013937363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner