Healthcare Provider Details

I. General information

NPI: 1528641560
Provider Name (Legal Business Name): YOLANDA ALISA COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 FRANKLIN SQUARE DR 9200 FRANKLIN SQUARE DR
BALTIMORE MD
21237-4458
US

IV. Provider business mailing address

11101 GEORGIA AVE
WHEATON MD
20902-4695
US

V. Phone/Fax

Practice location:
  • Phone: 410-391-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR271854
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAC003570
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: