JOHNNY KEITH COLEMAN P.A.-C. NPI 1174558845

NPI Information

  • NPI: 1174558845
  • Provider Name: JOHNNY KEITH COLEMAN, P.A.-C.
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 3302 RENNER DR
    FORTUNA, CA
    ZIP 95540
  • Phone: (707) 725-3318

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NPI Details

Johnny Keith Coleman, P.A.-C. is a primary care nurse practitioner in Fortuna, CA. Johnny Keith Coleman, P.A.-C. NPI is 1174558845. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3302 RENNER DR
FORTUNA, CA
ZIP 95540-103
Phone: (707) 725-3318
Fax: (707) 725-9396

The enumeration date for this NPI number is 7/11/2006 and was last updated on 6/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CarePA13661CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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