Provider Demographics
NPI:1891422101
Name:COLEMAN, CHRISTIAN (RN, CLC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SAINT NICHOLAS AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1915
Mailing Address - Country:US
Mailing Address - Phone:317-213-4677
Mailing Address - Fax:
Practice Address - Street 1:580 SAINT NICHOLAS AVE APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1915
Practice Address - Country:US
Practice Address - Phone:317-213-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY783541163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant