Provider Demographics
NPI:1942968763
Name:COLEMAN, CAROLYN HALL (PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:HALL
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 TANGLEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1267
Mailing Address - Country:US
Mailing Address - Phone:336-471-3621
Mailing Address - Fax:
Practice Address - Street 1:700 WALTER REED DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1128
Practice Address - Country:US
Practice Address - Phone:336-832-9601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021097717363LP0808X
NC5015443363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health