Provider Demographics
NPI:1649416330
Name:BRICE-COLEMAN, DEWONA CHEVELLE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:DEWONA
Middle Name:CHEVELLE
Last Name:BRICE-COLEMAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 E MARLENA ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2208
Mailing Address - Country:US
Mailing Address - Phone:626-922-4151
Mailing Address - Fax:
Practice Address - Street 1:2500 WILSHIRE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4310
Practice Address - Country:US
Practice Address - Phone:213-639-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN161053164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse