Healthcare Provider Details

I. General information

NPI: 1851220412
Provider Name (Legal Business Name): VANLISSA JORDAN COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N MONROE ST STE 3
MARKSVILLE LA
71351-2383
US

IV. Provider business mailing address

313 N MONROE ST STE 3
MARKSVILLE LA
71351-2383
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-7888
  • Fax: 337-407-5147
Mailing address:
  • Phone: 318-253-7888
  • Fax: 337-407-5147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18260
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: