Provider Demographics
NPI:1770339764
Name:COLEMAN, JHORDYN KASMERE
Entity type:Individual
Prefix:
First Name:JHORDYN
Middle Name:KASMERE
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 IROQUOIS DR APT F
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3975
Mailing Address - Country:US
Mailing Address - Phone:313-435-8500
Mailing Address - Fax:
Practice Address - Street 1:121 IROQUOIS DR APT F
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449-3975
Practice Address - Country:US
Practice Address - Phone:313-435-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide