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General NPI Number Information
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NPI Number | 1245965508
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Entity Type | Individual
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Provider Name | COLLEEN WHELEN
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 3082 MCMURRAY DR
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City | ANDERSON
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State | CA
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Zip | 96007-3544
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Country | US
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Telephone | 530-365-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 1993 GOREN CT
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City | REDDING
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State | CA
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Zip | 96003-0001
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Country | US
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Telephone | 530-355-6642
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95021849
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License Number State | CA
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