Healthcare Provider Details

I. General information

NPI: 1578481388
Provider Name (Legal Business Name): KYLAR JALEN COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 MANHATTAN BLVD STE 207
HARVEY LA
70058-3450
US

IV. Provider business mailing address

2349 MANHATTAN BLVD STE 207
HARVEY LA
70058-3450
US

V. Phone/Fax

Practice location:
  • Phone: 504-364-8949
  • Fax: 504-364-8968
Mailing address:
  • Phone: 504-364-8949
  • Fax: 504-364-8968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: