Healthcare Provider Details

I. General information

NPI: 1053207597
Provider Name (Legal Business Name): TAYLOR A COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 215
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

3906 92ND AVE
SPRINGDALE MD
20774-2503
US

V. Phone/Fax

Practice location:
  • Phone: 202-466-9719
  • Fax:
Mailing address:
  • Phone: 301-789-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: