Provider Demographics
NPI:1982003125
Name:COLEMAN, VICKYE (FNP)
Entity Type:Individual
Prefix:
First Name:VICKYE
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 1:3648 OLD DENTON RD
Mailing Address - Street 2:STE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-7978
Mailing Address - Country:US
Mailing Address - Phone:972-325-5855
Mailing Address - Fax:
Practice Address - Street 1:3648 OLD DENTON RD
Practice Address - Street 2:STE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-7978
Practice Address - Country:US
Practice Address - Phone:972-325-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX784577163W00000X
TXAP125806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse