MEDICARE: KATIE MARIE COLEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		IN

General Provider Information

NPI Number	:	1598520330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE MARIE COLEMAN

Provider Business Mailing Address
First Line	:	4119 APPLE CREEK DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-4814
Country	:	US
Telephone Number	:	317-540-8774
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 APPLE CREEK DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-4814
Country	:	US
Telephone Number	:	317-540-8774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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Directions to “ KATIE MARIE COLEMAN ” Practice Location

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