Kevin L Coleman, CRNA
Nurse Anesthetist, Certified Registered in Boise, ID. Individual provider (NPI-1).
NPI number1023045192
StatusActive
Last updated in NPPESNov 20, 2007
Details
- NPI
- 1023045192
- Entity type
- Individual (NPI-1)
- Name
- Kevin L Coleman
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 26, 2006
- Last updated
- Nov 20, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RNA305A | ID | Yes |
| 163W00000X | Registered Nurse | N22476 | ID |
Practice location
811 N Liberty StBoise, ID 83704-8703
Phone 208-323-4522
Mailing address
Po Box 4008Portland, OR 97208-4008
Phone 503-372-2740 · Fax 503-372-2754
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