Coleman, Carolyn D

Coleman, Carolyn D is an individual health care provider with primary practice located at 3450 Highway 80 W , Jackson MS 39209-7201. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Coleman, Carolyn D can be contacted via phone (601) 321-2400.

Contact Information

Primary practice address
3450 Highway 80 W Jackson MS 39209-7201
Phone: (601) 321-2400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X R789956 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R789956 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 789956 Mississippi

Profile Details

NPI number 1770897860
LBN Legal business name Coleman, Carolyn D
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2010
Last updated Dec 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770897860 NPPES
Mississippi MEDICAID 00151518

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