MEDICARE: NADINE V COLBERT III APRN

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	363L00000X	Nurse Practitioner	APRN53-74601-021	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	26575016	OTHER	BCBS OF KANSAS CITY

General Provider Information

NPI Number	:	1851322622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE V COLBERT III APRN

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	5026 WESCOE, MAIL STOP 2026
City	:	KANSAS CITY
State	:	KS
Zip	:	66160
Country	:	US
Telephone Number	:	913-588-6009
Fax Number	:	913-588-8182

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	5026 WESCOE, MAIL STOP 2026
City	:	KANSAS CITY
State	:	KS
Zip	:	66160
Country	:	US
Telephone Number	:	913-588-6009
Fax Number	:	913-588-8182

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	12/31/2014

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