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General NPI Number Information
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NPI Number | 1891932208
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Entity Type | Individual
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Provider Name | MARQUETTA D COLBERT MS, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 03/20/2022
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Provider Practice Location Address
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Address Line | 2580 SHILOH SPRINGS RD SUITE B
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City | TROTWOOD
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State | OH
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Zip | 45426-2151
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Country | US
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Telephone | 937-529-4376
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Fax | 937-529-4538
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Provider Business Mailing Address
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Address Line | 2580 SHILOH SPRINGS RD STE B
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City | TROTWOOD
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State | OH
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Zip | 45426-2100
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Country | US
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Telephone | 937-529-4376
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Fax | 937-529-4538
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2021118317
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA 10322-NP
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License Number State | OH
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