Organization
FULLY BLOOMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAQUEENA SHAUNTA COLEMAN FNP (NURSE PRACTITIONER)
(602) 661-3891
Entity
Organization
Contact information
Practice address
515 W. BUCKEYE RD., STE 406, PHOENIX, AZ 85003
(602) 661-3891
Mailing address
2942 N 24TH ST STE 115, PHOENIX, AZ 85016-7849
(602) 661-3891
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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