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General NPI Number Information
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NPI Number | 1356431050
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Entity Type | Individual
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Provider Name | COLLEEN K REILLY RN, APN
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/26/2013
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Provider Practice Location Address
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Address Line | 4 PLAZA DR SUITE 402
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City | SEWELL
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State | NJ
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Zip | 08080-2747
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Country | US
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Telephone | 856-270-4040
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Fax | 856-270-4044
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Provider Business Mailing Address
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Address Line | 3 COOPER PLZ SUITE 502
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-968-7433
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Fax | 856-968-8366
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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 | NR79808
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NN79808
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN322533L
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License Number State | PA
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