Provider Demographics
NPI:1881576676
Name:COLEMAN GAY, KESHAWNA (APRN)
Entity type:Individual
Prefix:
First Name:KESHAWNA
Middle Name:
Last Name:COLEMAN GAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14430 BARLEY FIELD DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-6165
Mailing Address - Country:US
Mailing Address - Phone:205-240-2272
Mailing Address - Fax:
Practice Address - Street 1:14430 BARLEY FIELD DR
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-6165
Practice Address - Country:US
Practice Address - Phone:205-240-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041110363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner