1336449610 NPI number — KARI KRISTEN COLEMAN CPNP

Table of content: KARI KRISTEN COLEMAN CPNP (NPI 1336449610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336449610 NPI number — KARI KRISTEN COLEMAN CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLEMAN
Provider First Name:
KARI
Provider Middle Name:
KRISTEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336449610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1475
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50305-1475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-643-6290
Provider Business Mailing Address Fax Number:
515-643-6291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 LAUREL ST
Provider Second Line Business Practice Location Address:
SUITE 3310
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50314-3017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-643-6290
Provider Business Practice Location Address Fax Number:
515-643-6281
Provider Enumeration Date:
11/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  C-110836 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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