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General NPI Number Information
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NPI Number | 1881229508
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Entity Type | Individual
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Provider Name | JOHN PAUL COLOSI
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Gender | Male
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 13129 S TRYON ST STE 120
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City | CHARLOTTE
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State | NC
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Zip | 28278-7915
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Country | US
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Telephone | 980-337-4662
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Fax | 980-337-4658
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Provider Business Mailing Address
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Address Line | 420 N CENTER ST
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City | HICKORY
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State | NC
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Zip | 28601-5033
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Country | US
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Telephone |
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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 | APN.23665
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License Number State | SC
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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 | 5012952
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License Number State | NC
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