Provider Demographics
NPI:1518293778
Name:COLEMAN, CATRICE LYNETTE (LPN)
Entity Type:Individual
Prefix:
First Name:CATRICE
Middle Name:LYNETTE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5465 KIRBY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1171
Mailing Address - Country:US
Mailing Address - Phone:513-222-4415
Mailing Address - Fax:
Practice Address - Street 1:5465 KIRBY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1171
Practice Address - Country:US
Practice Address - Phone:513-222-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH124934164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse