Basic Information
Provider Information
NPI: 1427381078
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COLEMAN
FirstName: HEATHER
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE STREET
Address2:  
City: LEXINGTON
State: KY
PostalCode: 40503
CountryCode: US
TelephoneNumber: 8593230100
FaxNumber:  
Practice Location
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 40506
CountryCode: US
TelephoneNumber: 5025830127
FaxNumber: 5025831239
Other Information
ProviderEnumerationDate: 09/15/2009
LastUpdateDate: 02/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0005X3006054KYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
363LN0000X3006054KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


Home