MRS. WANDRIA COLEMAN DALLAS (NPI# 1902370273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902370273 |
| Entity Type | Individual |
| Full Name | MRS. WANDRIA COLEMAN DALLAS |
| Credential | APRN |
| Practice Address |
1541 Kings Hwy Shreveport LA 71103-4228 |
| Mailing Address |
3902 Elmer Ln Shreveport LA 71109-1934 |
| Practice Telephone | 3186261855 |
| Practice Fax Number | 3186988182 |
| Mailing Telephone | 3185602295 |
| Enumeration Date | 2019-01-19 |
| Last Update Date | 2019-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
AP10195 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1541 KINGS HWY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912909912 | Brfhh Shreveport LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2005-08-10 |
| 1851991947 | Gina Marie Kristiansen | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-28 |
| 1376142893 | Candice Crow | Internal Medicine | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-26 |
| 1518574441 | Jadebrey Vyshette Kennon | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-24 |
| 1629683230 | Amanda Renae Simmons | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1255945382 | Frank James List | Pharmacy Technician | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-05 |
| 1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
| 1740899400 | Brittany Allyson Bozzell | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-29 |
| 1386253169 | Kristyn Turner | Pharmacist | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-28 |
| 1508481722 | Alexandra Blair Lemaire | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 364SG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740801786 | Gabriele R Serpas | Clinical Nurse Specialist | 15243 La Highway 10, Saint Francisville, LA 70775-4752 | 2020-04-30 |
| 1326464017 | Daniel R Seward | Clinical Nurse Specialist | 827 N Pine St, Gramercy, LA 70052-3659 | 2014-03-05 |
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on MRS. WANDRIA COLEMAN DALLAS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.