| NPI | 1134504087 |
|---|---|
| Former Name | GRETA RENEE COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009583) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3009583) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2023-07-01 |