Provider Demographics
NPI:1912024431
Name:COLEMAN, CINDY L (RN, MS, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:L
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN, MS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 KARR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ALMOND
Mailing Address - State:NY
Mailing Address - Zip Code:14804-9741
Mailing Address - Country:US
Mailing Address - Phone:607-276-6753
Mailing Address - Fax:
Practice Address - Street 1:19 PARK STREET
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802
Practice Address - Country:US
Practice Address - Phone:607-871-2400
Practice Address - Fax:607-871-2631
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332755-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01638Medicare UPIN