MEDICARE: YALANDA COLEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	P.N146082	OH

General Provider Information

NPI Number	:	1477168789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YALANDA COLEMAN

Provider Business Mailing Address
First Line	:	1571 BUNTS RD
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4514
Country	:	US
Telephone Number	:	216-762-3826
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 NOBLE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-1725
Country	:	US
Telephone Number	:	216-268-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	09/14/2020

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Directions to “ YALANDA COLEMAN ” Practice Location

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