Provider Demographics
NPI:1952555955
Name:COLEMAN, LOIS NAN (CNP)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:NAN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 HAMAKER CT
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2222
Mailing Address - Country:US
Mailing Address - Phone:703-698-8060
Mailing Address - Fax:703-876-4691
Practice Address - Street 1:3023 HAMAKER CT
Practice Address - Street 2:SUITE 210A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2222
Practice Address - Country:US
Practice Address - Phone:703-698-8060
Practice Address - Fax:703-876-4691
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024078700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024078700OtherSTATE LICENSE