Provider Demographics
NPI:1245665330
Name:COLEMAN, NONA LEI (MBA, LPN, MARS)
Entity type:Individual
Prefix:
First Name:NONA
Middle Name:LEI
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MBA, LPN, MARS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E BATTLEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-4802
Mailing Address - Country:US
Mailing Address - Phone:972-391-4305
Mailing Address - Fax:417-865-1007
Practice Address - Street 1:404 E BATTLEFIELD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4802
Practice Address - Country:US
Practice Address - Phone:972-391-4305
Practice Address - Fax:417-865-1007
Is Sole Proprietor?:No
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002005019164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse