Provider Demographics
NPI:1063179463
Name:COLEMAN, KATHERINE MAURA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAURA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MAURA
Other - Last Name:EISENMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3989 BRANDYCHASE WAY APT 215
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-4117
Mailing Address - Country:US
Mailing Address - Phone:740-408-2551
Mailing Address - Fax:
Practice Address - Street 1:1624 HERALD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-1099
Practice Address - Country:US
Practice Address - Phone:513-745-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer