Active NPI
Kiesha Coleman, N.P.
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1447523899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 21638
- Practice address
- 3958 Degnan Blvd
Los Angeles, CA 90008-2616 - Phone
- (323) 295-3745
- NPI assigned
- Feb 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21638 | CA | Primary |
Addresses
Primary practice location
3958 Degnan Blvd
Los Angeles, CA 90008-2616
Mailing address
3958 Degnan Blvd
Los Angeles, CA 90008-2616
Phone (323) 295-3745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21638 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329264000000",
"number": "1447523899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3958 DEGNAN BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900082616",
"telephone_number": "323-295-3745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3958 DEGNAN BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900082616",
"telephone_number": "323-295-3745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "KIESHA",
"credential": "N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-15",
"last_updated": "2012-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "21638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.