Healthcare Provider Details

I. General information

NPI: 1457063323
Provider Name (Legal Business Name): BIANCA COLMENARES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BIANCA COLMENARES DIAZ

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1463 BROOKHAVEN DR
ROCKINGHAM VA
22801-3584
US

IV. Provider business mailing address

1463 BROOKHAVEN DR
ROCKINGHAM VA
22801-3584
US

V. Phone/Fax

Practice location:
  • Phone: 904-304-5405
  • Fax:
Mailing address:
  • Phone: 904-303-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024185763
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: