Healthcare Provider Details

I. General information

NPI: 1083146336
Provider Name (Legal Business Name): JOSHUA ADAM COLLA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 MONTGOMERY RD STE 410
CINCINNATI OH
45212-2198
US

IV. Provider business mailing address

4805 MONTGOMERY RD STE 410
CINCINNATI OH
45212-2198
US

V. Phone/Fax

Practice location:
  • Phone: 513-241-2370
  • Fax:
Mailing address:
  • Phone: 513-241-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.020167
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.020167
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.020167
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: