Provider Demographics
NPI:1205131372
Name:COLEMAN, RYAN (RN)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 S COLORADO BLVD
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3304
Mailing Address - Country:US
Mailing Address - Phone:303-300-8740
Mailing Address - Fax:
Practice Address - Street 1:1385 S COLORADO BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3304
Practice Address - Country:US
Practice Address - Phone:303-300-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO128123163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator