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Individual

JEFFREY W COLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6451
Mailing address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6451

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
107583
MO
367500000X
Certified Registered Nurse Anesthetist
4045197
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
918628728
MO
01
P00267533
RAIL ROAD
Enumeration date
08/31/2006
Last updated
08/14/2025
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