Healthcare Provider Details

I. General information

NPI: 1417900507
Provider Name (Legal Business Name): COLENE E MARSHALL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 S ABILENE ST STE 100
AURORA CO
80014-2363
US

IV. Provider business mailing address

PO BOX 99
CONOWINGO MD
21918-0099
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-4779
  • Fax: 833-941-5047
Mailing address:
  • Phone: 410-378-9696
  • Fax: 410-378-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number45773
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1368499032
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR237865
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: