JOHNNY KEITH COLEMAN P.A.-C.
NPI 1174558845
Nurse Practitioner - Primary Care in Fortuna, CA

Active since July 11, 2006
3302 RENNER DR, FORTUNA, CA 95540(707) 725-3318(707) 725-9396 Get Directions Write a Review

NPPES record last updated: June 30, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Johnny Keith Coleman P.a.-c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNNY KEITH COLEMAN P.A.-C. (NPI 1174558845) is an individual primary care provider in Fortuna, California, licensed in California (PA13661) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1174558845
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameJOHNNY KEITH COLEMANCredential: P.A.-C.
Location Address3302 RENNER DRFortuna, CA 95540-7103
Mailing Address3302 Renner DrFortuna, CA 95540-3120 · (707) 725-3318 · Fax (707) 725-9396
Fax(707) 725-9396
Sole ProprietorNo
Enumeration DateJuly 11, 2006
Last NPPES UpdateJune 30, 2015
NPI 1174558845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in CA · PA13661
3302 RENNER DR, Fortuna, CA 95540

Other Names 1

Other Name (5)John K Coleman Pa-c

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
3302 RENNER DR
FORTUNA, CA 95540
Clinic/Center (Rural Health)
3302 RENNER DR
FORTUNA, CA 95540
Family Medicine
3302 RENNER DR
FORTUNA, CA 95540
Family Medicine
3302 RENNER DR
FORTUNA, CA 95540
Family Medicine
3302 RENNER DR
FORTUNA, CA 95540
Nurse Practitioner (Primary Care)
3302 RENNER DR
FORTUNA, CA 95540

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnny Coleman's NPI number?

The NPI number for Johnny Coleman is 1174558845. It was assigned to this individual provider in the NPPES registry on July 11, 2006. The provider is also known as John K Coleman Pa-C.

Where is Johnny Coleman located?

Johnny Coleman practices at 3302 Renner Dr, Fortuna, CA 95540. The listed phone number is (707) 725-3318.

What is Johnny Coleman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Johnny Coleman was last updated on June 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.