Doctor Name: | MRS. SUZANNE KRISTINE COLEMAN |
NPI Number: | 1720377914 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 4704200789 |
Business Practice Address: | 4641 S Quarry Crk White Lake, MI - 483831872 |
Business Phone Number: | 2487149629 |
Business Fax Number: | |
Mailing Address: | 4641 S Quarry Crk, WHITE LAKE |
State: | MI |
Postal Code: | 483831872 |
Phone Number: | 2487149629 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2011 |
NPI Last Update Date: | 03/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704200789 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |