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1164480281 NPI number — SHEILA MARIE MCCOLLAM FNP - BC

NPI Number: 1164480281
Health Care Provider/Practitioner: SHEILA MARIE MCCOLLAM FNP - BC

Information about “1164480281” NPI (SHEILA MARIE MCCOLLAM FNP - BC) exists in 1164480281 in HTML format HTML  |  1164480281 in plain Text format TXT  |  1164480281 in PDF (Portable Document Format) PDF  |  1164480281 in an XML format XML  formats.

NPI Number : 1164480281 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164480281",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCCOLLAM",
    "FirstName": "SHEILA",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "FNP - BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KUPERSMITH",
    "OtherFirstName": "SHEILA",
    "OtherMiddleName": "CHRISTENSON",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "FNP - BC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1626 BEAMREACH PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT COLLINS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80524-6743",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "970-682-0465",
    "MailingAddressFaxNumber": "844-726-8896",
    "FirstLinePracticeLocationAddress": "401 MASON CT",
    "SecondLinePracticeLocationAddress": "SUITE 101",
    "PracticeLocationAddressCityName": "FORT COLLINS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80524",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-829-0077",
    "PracticeLocationAddressFaxNumber": "844-726-8896",
    "EnumerationDate": "05/01/2006",
    "LastUpdateDate": "08/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "0991742",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "937",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "APN0991742-NP",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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