Provider Demographics
NPI:1760261978
Name:COLEMAN, BEVERLY
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
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 1:2400 HAMPDEN DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-1686
Mailing Address - Country:US
Mailing Address - Phone:517-977-1532
Mailing Address - Fax:517-977-1532
Practice Address - Street 1:2400 HAMPDEN DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-1686
Practice Address - Country:US
Practice Address - Phone:517-977-1532
Practice Address - Fax:517-977-1532
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker