Provider Demographics
NPI:1205621877
Name:COLEMAN, KANAY EVONNE
Entity type:Individual
Prefix:
First Name:KANAY
Middle Name:EVONNE
Last Name:COLEMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 PEPPERHILL DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2142
Mailing Address - Country:US
Mailing Address - Phone:314-326-6488
Mailing Address - Fax:
Practice Address - Street 1:1545 PEPPERHILL DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2142
Practice Address - Country:US
Practice Address - Phone:314-326-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula