Provider Demographics
NPI:1568741445
Name:COLEMAN, MICHELE LYN (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 W NEWBERRY RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:FL
Practice Address - Zip Code:32693-3462
Practice Address - Country:US
Practice Address - Phone:352-246-8566
Practice Address - Fax:734-322-0384
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9246703363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics