Provider Demographics
NPI:1164257671
Name:COLEMAN, CRISTIAN (RN)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CRYSTAL BAY RD
Mailing Address - Street 2:
Mailing Address - City:SEMORA
Mailing Address - State:NC
Mailing Address - Zip Code:27343-9098
Mailing Address - Country:US
Mailing Address - Phone:919-698-6271
Mailing Address - Fax:
Practice Address - Street 1:3643 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2702
Practice Address - Country:US
Practice Address - Phone:919-470-8612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145080163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology