Provider Demographics
NPI:1386181071
Name:COATES, MADONNA (HHA)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:
Last Name:COATES
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 4TH ST SE
Mailing Address - Street 2:APT.5
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3395
Mailing Address - Country:US
Mailing Address - Phone:202-971-6198
Mailing Address - Fax:
Practice Address - Street 1:4327 4TH ST SE
Practice Address - Street 2:APT.5
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3395
Practice Address - Country:US
Practice Address - Phone:202-971-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12601374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide