Provider Demographics
NPI:1699180588
Name:COLEMAN, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 CHIPPEWA DR
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9143
Mailing Address - Country:US
Mailing Address - Phone:740-497-2931
Mailing Address - Fax:
Practice Address - Street 1:18750 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURELVILLE
Practice Address - State:OH
Practice Address - Zip Code:43135-7518
Practice Address - Country:US
Practice Address - Phone:740-497-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator