| NPI | 1447633763 |
|---|---|
| Former Name | SHANNON LORRAINE COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9278663) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ARNP9278663) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2024-01-19 |