MEDICARE: COLIN VO FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP1050932	TX

General Provider Information

NPI Number	:	1043172620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLIN VO FNP-C

Provider Business Mailing Address
First Line	:	5512 GEM LAKE RD STE 500
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-4227
Country	:	US
Telephone Number	:	806-718-5130
Fax Number	:	806-718-5131

Provider Business Practice Location Address
First Line	:	5512 GEM LAKE RD STE 500
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-4227
Country	:	US
Telephone Number	:	806-718-5130
Fax Number	:	806-718-5131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ COLIN VO FNP-C” Practice Location

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