Provider Demographics
NPI:1548094709
Name:EMMANUEL, YASMIN SHANTA
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:SHANTA
Last Name:EMMANUEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YASMINASMIN
Other - Middle Name:SHANTA
Other - Last Name:EMMANUEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CALABASHHELPINGHANDS
Mailing Address - Street 1:7185 GRAND CASCADE PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3161
Mailing Address - Country:US
Mailing Address - Phone:931-436-1807
Mailing Address - Fax:
Practice Address - Street 1:7185 GRAND CASCADE PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-3161
Practice Address - Country:US
Practice Address - Phone:931-436-1807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONA.00794911374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide