Provider Demographics
NPI:1316378748
Name:PRINCE-COLEMAN, ELIZABETH HUFF (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HUFF
Last Name:PRINCE-COLEMAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1499 WALTON WAY
Mailing Address - Street 2:STE. 1400
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2602
Mailing Address - Country:US
Mailing Address - Phone:706-721-2798
Mailing Address - Fax:706-721-1115
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0004
Practice Address - Country:US
Practice Address - Phone:706-721-2798
Practice Address - Fax:706-721-1115
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2014-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA7065363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant