Provider Demographics
NPI:1811142599
Name:COLEMAN, ABIGAIL (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:SCHUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:20 HILLSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1818
Mailing Address - Country:US
Mailing Address - Phone:603-986-9886
Mailing Address - Fax:
Practice Address - Street 1:20 HILLSIDE CIR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1818
Practice Address - Country:US
Practice Address - Phone:603-986-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-23
Last Update Date:2008-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003338133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered