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General NPI Number Information
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NPI Number | 1366361560
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Entity Type | Individual
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Provider Name | JAMYIAH LAQUAN COACHMAN CNM,WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 29 UPPER RIVERDALE RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2616
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Country | US
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Telephone | 770-268-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 W PEACHTREE ST NW APT 2313
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City | ATLANTA
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State | GA
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Zip | 30309-4747
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 104884213
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | CNM10879
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License Number State | GA
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