Provider Demographics
NPI:1629280847
Name:COLEMAN, NANCY N (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:N
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:545 ETHERIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322
Mailing Address - Country:US
Mailing Address - Phone:757-547-3135
Mailing Address - Fax:757-548-3678
Practice Address - Street 1:733 VOLVO PARKWAY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-3135
Practice Address - Fax:757-548-3678
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist