Provider Demographics
NPI:1710520333
Name:COLEMAN-NURSE PRACTITIONER, PAUL (NP, PMHNP, APRN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:COLEMAN-NURSE PRACTITIONER
Suffix:
Gender:M
Credentials:NP, PMHNP, APRN
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:COLEMAN, PSYCH NURSE PRACTITIONER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP, PMHNP, APRN
Mailing Address - Street 1:132 CENTRAL ST STE 107
Mailing Address - Street 2:
Mailing Address - City:FOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2422
Mailing Address - Country:US
Mailing Address - Phone:857-201-0406
Mailing Address - Fax:617-687-5920
Practice Address - Street 1:132 CENTRAL ST STE 107
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2422
Practice Address - Country:US
Practice Address - Phone:857-201-0406
Practice Address - Fax:617-687-5920
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-27
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN278566363LP0808X
MAAPRN278566363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health