Individual
JORDAN ANDREW COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
130 MAY MORNING DR, LEXINGTON, SC 29073-9440
(803) 608-8034
Mailing address
130 MAY MORNING DR, LEXINGTON, SC 29073-9440
(803) 608-8034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
217780
SC
367500000X
Certified Registered Nurse Anesthetist
1477056281
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
21973
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2775
—
SC
Enumeration date
03/18/2018
Last updated
04/20/2023
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