SERENA M COULOMBE (NPI# 1508802166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508802166 |
| Entity Type | Individual |
| Full Name | SERENA M COULOMBE |
| Credential | CRNP |
| Practice Address |
Clark-holder Clinic, P.a. 303 Smith Street Lagrange GA 30240 |
| Practice Telephone | 7068828831 |
| Practice Fax Number | 7068124091 |
| Mailing Telephone | 7068828831 |
| Mailing Fax Number | 7068124091 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
51998 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
CLARK-HOLDER CLINIC, P.A. 303 SMITH STREET |
| City | LAGRANGE |
| State | GA |
| Zip Code | 30240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205871233 | Shih Yin Anna Kao | Ophthalmology | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-16 |
| 1487682373 | Clark-holder Clinic, P.a. | Family Medicine | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-29 |
| 1801822978 | Diane L Mcgowan | Otolaryngology | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-23 |
| 1629014907 | Kevin R Ward | Nurse Practitioner | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-22 |
| 1972549269 | Mary Katherine Williams | Nurse Practitioner | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-22 |
| 1932145125 | Tracy W. Flory | Nurse Practitioner | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-22 |
| 1649216839 | Nancy H Perry | Nurse Practitioner | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-22 |
| 1780620344 | Marlis J Dunlap | Nurse Practitioner | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-21 |
| 1831135987 | James P Mcgowan | Internal Medicine | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-20 |
| 1447295696 | Lawrence N Gynther | Internal Medicine | Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 | 2006-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598223844 | Urgencare, LLC | Clinic/Center | 2169 West Point Road, Suite 105, Lagrange, GA 30240 | 2019-03-06 |
| 1679075527 | Georgia Pain and Spine Care, Inc | Pain Medicine | 303 Smith St Fl 2, Lagrange, GA 30240 | 2018-03-07 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1770913964 | Dell H Lawson | Counselor | 300 Medical Dr. Ste 705., Lagrange, GA 30240 | 2013-11-25 |
| 1629418793 | Mortar & Pestle, LLC | Pharmacy | 205 Vernon Street, Lagrange, GA 30240 | 2013-07-03 |
| 1336582329 | Weredeselam Menna Olango | Psychiatry & Neurology | 303 Medical Dr Ste 401, Lagrange, GA 30240 | 2013-04-10 |
| 1720333743 | Mortar and Pestle, LLC | Pharmacy | 300 Mooty Bridge Road, Lagrange, GA 30240 | 2012-07-16 |
| 1366768459 | Karin Taylor | Physical Medicine & Rehabilitation | 1600 Vernon Rd Ste A, Lagrange, GA 30240 | 2010-04-14 |
| 1871819458 | Kathryn J Hill | Counselor | 100 Smith St Ste 1, Lagrange, GA 30240 | 2010-04-08 |
| 1285802751 | Air Evac Ems, Inc. | Ambulance | 455 Aerotron Pkwy, Lagrange, GA 30240 | 2008-02-18 |
| Find all providers in zip 30240 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902342835 | Taylor Jones Moss | Nurse Practitioner | 1514 Vernon Rd, Lagrange, GA 30240-4131 | 2017-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1427657113 | Cynthia Diane Prather | Nurse Practitioner | 3264 Lower Boston Rd, Thomasville, GA 31757-1311 | 2020-10-22 |
| 1932706728 | Alecia Ann Czarnecki | Nurse Practitioner | 6240 Crooked Creek Dr, Rex, GA 30273-5006 | 2020-10-05 |
| 1801401112 | Cotenna D. Clark | Nurse Practitioner | 1857 Cameo Ct, Tucker, GA 30084-7002 | 2020-09-14 |
| 1487264370 | Helen Young Yates | Nurse Practitioner | 40 Red Rock Ct Ne, Ludowici, GA 31316-6280 | 2020-08-05 |
| 1982214334 | Jasmine Alecia Henderson | Nurse Practitioner | 52 Roseberry Cir, Port Wentworth, GA 31407-5612 | 2020-07-31 |
| 1275142994 | Theresia Richardson | Nurse Practitioner | 2033 Buford Hwy Ste 109, Buford, GA 30518-8802 | 2020-07-28 |
| 1063021277 | Elsa Duncan Duncan | Nurse Practitioner | 1822 E Gwinnett St, Savannah, GA 31404-1853 | 2020-07-24 |
| 1154941946 | Joy P Wharton | Nurse Practitioner | 182 Silver Arrow Cir, Austell, GA 30168-7490 | 2020-04-21 |
| 1235769985 | Michelle Brack | Nurse Practitioner | 502 Hall Rd, Thomasville, GA 31757-8105 | 2020-01-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.