COLBERT FAMILY HEALTH AND WELLNESS LLC NPI 1619295425

NPI Information

NPI: 1619295425
Provider Name: COLBERT FAMILY HEALTH AND WELLNESS, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 36D2225282

Address:
2580 SHILOH SPRINGS RD
DAYTON, OH
ZIP 45426
Phone: (937) 529-4376
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COLBERT FAMILY HEALTH AND WELLNESS, LLC is a psychiatric/mental health nurse practitioner in Dayton, OH. COLBERT FAMILY HEALTH AND WELLNESS, LLC NPI is 1619295425. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2580 SHILOH SPRINGS RD
DAYTON, OH
ZIP 45426-151
Phone: (937) 529-4376
Fax: (937) 529-4538

The provider's authorized official is Marquetta D Colbert .
The authorized official title is Owner and has the following contact phone number (937) 529-4376.

The CLIA number assigned to this NPI record is 36D2225282 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2010 and was last updated on 3/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	NP-10322	OHIO	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1891932208	OTHER	OHIO	INDIVIDUAL NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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