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NPI Code Detail

MEDICARE: TIFFANY SHINEE COLEMAN

MEDICARE: TIFFANY SHINEE 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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1699244517
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY SHINEE COLEMAN
Provider Business Mailing Address
First Line : 3315 E RUSSELL RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3440
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1771 E FLAMINGO RD STE 220A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0850
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2018
Last Update Date : 11/20/2018

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Directions to “ TIFFANY SHINEE COLEMAN ” Practice Location

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