Provider Demographics
NPI:1881046464
Name:COLEMAN, CLAUDE VERNON (LVN)
Entity type:Individual
Prefix:
First Name:CLAUDE
Middle Name:VERNON
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 O ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0624
Mailing Address - Country:US
Mailing Address - Phone:707-442-7668
Mailing Address - Fax:707-443-8839
Practice Address - Street 1:305 O ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0624
Practice Address - Country:US
Practice Address - Phone:707-442-7668
Practice Address - Fax:707-443-8839
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN126085164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse