Healthcare Provider Details

I. General information

NPI: 1528794997
Provider Name (Legal Business Name): COLLEEN KEARNEY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4988 STATE HIGHWAY 30
AMSTERDAM NY
12010-7520
US

IV. Provider business mailing address

2464 HILLTOP RD
NISKAYUNA NY
12309-2405
US

V. Phone/Fax

Practice location:
  • Phone: 518-841-7341
  • Fax: 518-770-7520
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407268
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: