MEDICARE: MRS. COLLEEN DIFERDINANDO APN

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	APN.0995334-NP	CO
2	363LF0000X	Family Nurse Practitioner	APRN-5883	HI
3	363LF0000X	Family Nurse Practitioner	88995	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RXN.0104615-NP	OTHER	CO	CO RXN LICENSE
2	APN.0995334-NP	OTHER	CO	CO APN LICENSE
3	RN.1627319	OTHER	CO	CO RN LICENSE

General Provider Information

NPI Number	:	1558946533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLLEEN DIFERDINANDO APN

Provider Business Mailing Address
First Line	:	2620 ELM HILL PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8354 E NORTHFIELD BLVD STE 3700
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-3131
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

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

Provider Enumeration Date	:	03/11/2021
Last Update Date	:	04/30/2026

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