Provider Demographics
NPI:1689815565
Name:COLEMAN, LILLIAN ELAINE (CRNP)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:ELAINE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 STOUDTS FERRY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-1445
Mailing Address - Country:US
Mailing Address - Phone:610-334-1788
Mailing Address - Fax:
Practice Address - Street 1:48 S 4TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1047
Practice Address - Country:US
Practice Address - Phone:610-376-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP005906T364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal