=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770982241
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATIA COLEY NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2014
-----------------------------------------------------
Last Update Date | 12/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5501 TWIN KNOLLS RD STE 107
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21045-3260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-690-2272
-----------------------------------------------------
Fax | 855-450-1084
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7107 BROOKSHIRE LN
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21029-1733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-690-2272
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | R177957
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R177957
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------