1710520333 NPI number — MR. PAUL COLEMAN-NURSE PRACTITIONER NP, PMHNP, APRN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710520333 NPI number — MR. PAUL COLEMAN-NURSE PRACTITIONER NP, PMHNP, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLEMAN-NURSE PRACTITIONER
Provider First Name:
PAUL
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
NP, PMHNP, APRN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLEMAN, PSYCH NURSE PRACTITIONER
Provider Other First Name:
PAUL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP, PMHNP, APRN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1710520333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
132 CENTRAL ST STE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOXBOROUGH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02035-2422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-201-0406
Provider Business Mailing Address Fax Number:
617-687-5920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
132 CENTRAL ST STE 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOXBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02035-2422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-201-0406
Provider Business Practice Location Address Fax Number:
617-687-5920
Provider Enumeration Date:
10/27/2019

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: 363LP0808X , with the licence number:  RN278566 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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