| NPI | 1437493210 |
|---|---|
| Former Name | AMANDA JO COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN 151308-M-IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.151308.MEDS-IV) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2024-03-20 |