Provider Demographics
NPI:1134007271
Name:COLEMAN, BRAYDEN CHRISTOPHER
Entity type:Individual
Prefix:
First Name:BRAYDEN
Middle Name:CHRISTOPHER
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-6810
Mailing Address - Country:US
Mailing Address - Phone:304-898-6276
Mailing Address - Fax:
Practice Address - Street 1:2401 24TH AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-6810
Practice Address - Country:US
Practice Address - Phone:304-898-6276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant