MEDICARE: KATHY COLAHAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R210603	MN

General Provider Information

NPI Number	:	1205650215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY COLAHAR

Provider Business Mailing Address
First Line	:	22 W PADONIA RD STE C252
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-2241
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 W PADONIA RD STE C252
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-2241
Country	:	US
Telephone Number	:	410-672-7028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2024
Last Update Date	:	11/15/2024

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Directions to “ KATHY COLAHAR ” Practice Location

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