Provider Demographics
NPI:1457676397
Name:COLEMAN, KIMBERLY ANNE (MSN, APN,C)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MSN, APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2373
Mailing Address - Country:US
Mailing Address - Phone:215-322-4559
Mailing Address - Fax:
Practice Address - Street 1:446 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4502
Practice Address - Country:US
Practice Address - Phone:609-394-4000
Practice Address - Fax:609-815-7231
Is Sole Proprietor?:No
Enumeration Date:2010-04-04
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06855600163W00000X
NJ26NC06855600163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse