Provider Demographics
NPI:1891568960
Name:COLEMAN, ARLESUAH Y
Entity Type:Individual
Prefix:
First Name:ARLESUAH
Middle Name:Y
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ARBOR COVE WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6443
Mailing Address - Country:US
Mailing Address - Phone:205-767-4915
Mailing Address - Fax:
Practice Address - Street 1:121 ARBOR COVE WAY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6443
Practice Address - Country:US
Practice Address - Phone:205-767-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030089196282E00000X, 310400000X, 364SL0600X, 374U00000X, 376K00000X, 283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren
No282E00000XHospitalsLong Term Care Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide