Provider Demographics
NPI:1750175311
Name:COLEMAN, JOHANNA
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 WOODBINE RD
Mailing Address - Street 2:
Mailing Address - City:AIRVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17302-9018
Mailing Address - Country:US
Mailing Address - Phone:401-234-3935
Mailing Address - Fax:
Practice Address - Street 1:1505 WOODBINE RD
Practice Address - Street 2:
Practice Address - City:AIRVILLE
Practice Address - State:PA
Practice Address - Zip Code:17302-9018
Practice Address - Country:US
Practice Address - Phone:401-234-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife