| Doctor Name: | CANDICE L COLEMAN |
| NPI Number: | 1073912366 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BSN |
| License Number: | R879573 |
| Business Practice Address: | 341 Mallory Dr Byram, MS - 392726422 |
| Business Phone Number: | 6015739165 |
| Business Fax Number: | |
| Mailing Address: | 341 Mallory Dr, BYRAM |
| State: | MS |
| Postal Code: | 39272 |
| Phone Number: | 6015739165 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2014 |
| NPI Last Update Date: | 08/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | R879573 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |