Provider Demographics
NPI:1720535743
Name:COLEMAN, ASHANTI (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHANTI
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240
Mailing Address - Street 2:N. BYHALIA ROAD
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017
Mailing Address - Country:US
Mailing Address - Phone:901-492-4920
Mailing Address - Fax:
Practice Address - Street 1:1444 E SHELBY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7260
Practice Address - Country:US
Practice Address - Phone:901-396-8366
Practice Address - Fax:901-346-1413
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily