Individual
MRS. AUDREY BECKER COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 A1A S, ST AUGUSTINE, FL 32080-6615
(904) 605-3553
Mailing address
1009 11TH ST N, JACKSONVILLE BEACH, FL 32250-3693
(629) 221-1185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6089376
BCBS TN
TN
05
—
Q025828
—
TN
Enumeration date
09/07/2016
Last updated
11/24/2024
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