Provider Demographics
NPI:1912051343
Name:COLEMAN, TAMIKA DARNICE
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:DARNICE
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 1:12624 BRITTON DR
Mailing Address - Street 2:DOWN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1011
Mailing Address - Country:US
Mailing Address - Phone:216-233-2345
Mailing Address - Fax:216-229-8827
Practice Address - Street 1:12624 BRITTON DR
Practice Address - Street 2:DOWN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1011
Practice Address - Country:US
Practice Address - Phone:216-233-2345
Practice Address - Fax:216-229-8827
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2679758374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide