Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024168958 | VA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024168958 | VA |
NPI | 1396052809 |
---|---|
Provider Name | Nicole Marie Socha-Coleman |
First Address | Roanoke, VA 24018 |
Second Address | Roanoke, VA 24018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2010 |
Last Update Date | 03/09/2010 |