Provider Demographics
NPI:1700662277
Name:COLEMAN, ANDREA (LHHA)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LHHA
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 G STREET SW
Mailing Address - Street 2:APTB319
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024
Mailing Address - Country:US
Mailing Address - Phone:202-274-0025
Mailing Address - Fax:
Practice Address - Street 1:3016 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2524
Practice Address - Country:US
Practice Address - Phone:302-023-7300
Practice Address - Fax:202-373-0336
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA20002993374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide