Provider Demographics
NPI:1215262191
Name:COLEMAN, PATRICIA MAY (FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MAY
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2782 AUGUST RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-3923
Mailing Address - Country:US
Mailing Address - Phone:843-270-8853
Mailing Address - Fax:
Practice Address - Street 1:2782 AUGUST RD
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-3923
Practice Address - Country:US
Practice Address - Phone:843-270-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1516Medicaid
SCNP1516Medicaid