| NPI | 1225548449 |
|---|---|
| Former Name | KELLY MICHELLE COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110773) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9344781) |
| 363A00000X Physician Assistant (Licence: GA PA008657) | |
| 363A00000X Physician Assistant (Licence: FL PA9110773) | |
| 376K00000X Nurse's Aide (Licence: FL CNA222035) | |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2024-06-04 |