Provider Demographics
NPI:1033089685
Name:COLEMAN, JAMES DARRELL
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DARRELL
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 9TH AVE W APT 2
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-2415
Mailing Address - Country:US
Mailing Address - Phone:701-730-1649
Mailing Address - Fax:
Practice Address - Street 1:925 9TH AVE W APT 2
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-2415
Practice Address - Country:US
Practice Address - Phone:701-730-1649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant