Provider Demographics
NPI:1215765102
Name:DONALD-COLEMAN, FELECIA R (RN)
Entity type:Individual
Prefix:
First Name:FELECIA
Middle Name:R
Last Name:DONALD-COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9161 AUDUBON RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2501
Mailing Address - Country:US
Mailing Address - Phone:586-646-6295
Mailing Address - Fax:
Practice Address - Street 1:18121 E 8 MILE RD STE 105
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3245
Practice Address - Country:US
Practice Address - Phone:586-646-6295
Practice Address - Fax:248-747-8377
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2024402172V00000X
MI4704187312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No172V00000XOther Service ProvidersCommunity Health Worker