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NPI Code Detail

MEDICARE: MS. COURTNEY C COLOBRO

MEDICARE: MS. COURTNEY C COLOBRO
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
1163WC0200XCritical Care Medicine Registered Nurse175777TN
2363LP0808XPsychiatric/Mental Health Nurse Practitioner35682TN

General Provider Information

NPI Number : 1235853425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. COURTNEY C COLOBRO
Provider Business Mailing Address
First Line : 2316 BRIARCLIFF RD
Second Line :
City : KINGSPORT
State : TN
Zip : 37660-4711
Country : US
Telephone Number : 865-803-6618
Fax Number :
Provider Business Practice Location Address
First Line : 245 MIDWAY MEDICAL PARK
Second Line :
City : BRISTOL
State : TN
Zip : 37620-1653
Country : US
Telephone Number : 423-652-0260
Fax Number : 423-652-0694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2022
Last Update Date : 11/29/2024

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Directions to “ MS. COURTNEY C COLOBRO ” Practice Location

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