Provider Demographics
NPI:1417432972
Name:COLEMAN, WENDY M (RN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3555
Mailing Address - Country:US
Mailing Address - Phone:531-299-2521
Mailing Address - Fax:531-299-2538
Practice Address - Street 1:5120 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3555
Practice Address - Country:US
Practice Address - Phone:531-299-2521
Practice Address - Fax:531-299-2538
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59318163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool