Provider Demographics
NPI:1548349467
Name:COLEMAN, JENNIFER LEE (FNP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 SLIDE RD UNIT 4B
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-5402
Mailing Address - Country:US
Mailing Address - Phone:806-793-8447
Mailing Address - Fax:806-687-0337
Practice Address - Street 1:1126 SLIDE RD UNIT 4B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-5402
Practice Address - Country:US
Practice Address - Phone:806-793-8447
Practice Address - Fax:806-687-0337
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily