Provider Demographics
NPI:1598582066
Name:COLEMAN, ADRIENNE MARIE (RN)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MARIE
Other - Last Name:SHERMAN, KONCUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ROBERTS RD APT 131
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-3305
Mailing Address - Country:US
Mailing Address - Phone:218-303-6011
Mailing Address - Fax:
Practice Address - Street 1:700 ROBERTS RD APT 131
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-3305
Practice Address - Country:US
Practice Address - Phone:218-303-6011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2411480163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse