Provider Demographics
NPI:1710122247
Name:COLEMAN, CHRISTY LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 EAST PARRISH AVENUE
Mailing Address - Street 2:BUILDING E SUITE 101
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303
Mailing Address - Country:US
Mailing Address - Phone:270-852-1655
Mailing Address - Fax:270-297-4967
Practice Address - Street 1:2200 EAST PARRISH AVENUE
Practice Address - Street 2:BUILDING E SUITE 101
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303
Practice Address - Country:US
Practice Address - Phone:270-852-1655
Practice Address - Fax:270-297-4967
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000599551OtherANTHEM CROFTON
KY000000599302OtherANTHEM
KY7100107280Medicaid
KY000000599551OtherANTHEM CROFTON