MEDICARE: MRS. KATIA COLEY NP-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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R177957	MD
2	363LF0000X	Family Nurse Practitioner	R177957	MD

General Provider Information

NPI Number	:	1770982241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATIA COLEY NP-C

Provider Business Mailing Address
First Line	:	7107 BROOKSHIRE LN
Second Line	:
City	:	CLARKSVILLE
State	:	MD
Zip	:	21029-1733
Country	:	US
Telephone Number	:	443-690-2272
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 TWIN KNOLLS RD STE 107
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-3260
Country	:	US
Telephone Number	:	443-690-2272
Fax Number	:	855-450-1084

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

Provider Enumeration Date	:	08/20/2014
Last Update Date	:	12/03/2025

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