Provider Demographics
NPI:1497030894
Name:COLEMAN, NAKIA (NNP-BC)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:NAKIA
Other - Middle Name:
Other - Last Name:ROLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP-BC
Mailing Address - Street 1:7062 LARKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1350
Mailing Address - Country:US
Mailing Address - Phone:662-420-7306
Mailing Address - Fax:
Practice Address - Street 1:877 JEFFERSON AVE
Practice Address - Street 2:ROUT BLDG
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2807
Practice Address - Country:US
Practice Address - Phone:901-545-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15357363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal