Individual
ANTOINETTE SUE COALSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 ARCADE AVE STE 210, ELKHART, IN 46514-2485
(574) 389-5656
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1817
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004495A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004495A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201190320
—
IN
Enumeration date
07/02/2013
Last updated
05/01/2023
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