MEDICARE: CHELSEA LOUISE COLBY AGACNP-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
1	163W00000X	Registered Nurse	232456	AZ
2	363LA2100X	Acute Care Nurse Practitioner	232456	AZ

General Provider Information

NPI Number	:	1568271153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA LOUISE COLBY AGACNP-BC

Provider Business Mailing Address
First Line	:	15815 S LAKEWOOD PKWY W APT 1059
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-5847
Country	:	US
Telephone Number	:	575-405-9932
Fax Number	:

Provider Business Practice Location Address
First Line	:	9060 E VIA LINDA
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5422
Country	:	US
Telephone Number	:	480-614-2000
Fax Number	:

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

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	04/09/2025

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