Provider Demographics
NPI:1093578536
Name:COLEMAN, TIFFANY BARKSDALE (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:BARKSDALE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 HADDON DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-9348
Mailing Address - Country:US
Mailing Address - Phone:757-560-3472
Mailing Address - Fax:
Practice Address - Street 1:4103 HADDON DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-9348
Practice Address - Country:US
Practice Address - Phone:757-560-3472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC275558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse