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NPI Code Detail

MEDICARE: SHONDA LYNN COLELLA APRN

MEDICARE:   SHONDA LYNN COLELLA  APRN
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 Practitioner77735KS

General Provider Information

NPI Number : 1538689229
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHONDA LYNN COLELLA APRN
Provider Business Mailing Address
First Line : 8750 S WEBB RD
Second Line :
City : DERBY
State : KS
Zip : 67037-9629
Country : US
Telephone Number : 316-210-1184
Fax Number :
Provider Business Practice Location Address
First Line : 3417 S MERIDIAN AVE
Second Line :
City : WICHITA
State : KS
Zip : 67217-2151
Country : US
Telephone Number : 316-866-2000
Fax Number : 316-866-2084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2017
Last Update Date : 11/22/2019

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Directions to “ SHONDA LYNN COLELLA APRN” Practice Location

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