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NPI Code Detail

MEDICARE: MS. CONSTANCE R COLBERT FNP-BC

MEDICARE: MS. CONSTANCE R COLBERT FNP-BC
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
1363LF0000XFamily Nurse PractitionerAP3120AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z130103OTHERAZMEDICARE ID #

General Provider Information

NPI Number : 1205083839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CONSTANCE R COLBERT FNP-BC
Provider Business Mailing Address
First Line : 3300 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3030
Country : US
Telephone Number : 602-639-6215
Fax Number : 602-639-7830
Provider Business Practice Location Address
First Line : 3300 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3030
Country : US
Telephone Number : 602-639-6215
Fax Number : 602-639-7830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 10/21/2023

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