Provider Demographics
NPI:1285450502
Name:COLEMAN, JENNIFER KAY
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3438
Mailing Address - Country:US
Mailing Address - Phone:567-525-6349
Mailing Address - Fax:
Practice Address - Street 1:619 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3438
Practice Address - Country:US
Practice Address - Phone:567-525-6349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRY858432374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide