MS. MARY BOURNE COLLO (NPI# 1932136728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932136728 |
| Entity Type | Individual |
| Full Name | MS. MARY BOURNE COLLO |
| Credential | ANP05/ |
| Practice Address |
650 E. Indian School Road Research Service Phoenix AZ 85012-1892 |
| Mailing Address |
1408 E Marshall Ave Phoenix AZ 85014-2358 |
| Practice Telephone | 6022775551 |
| Practice Fax Number | 6022122097 |
| Mailing Telephone | 6022309336 |
| Mailing Fax Number | 6022777824 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN018619 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
650 E. INDIAN SCHOOL ROAD RESEARCH SERVICE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-1892 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891088589 | Megan Frances Dorner | Speech-Language Pathologist | 650 E. Indian School Road, Audiology and Speech Pathology (126), Phoenix, AZ 85012-1892 | 2011-05-27 |
| 1972768836 | Kimberly Diane Kilde | Dietitian, Registered | 650 E. Indian School Road, Phoenix, AZ 85012-1892 | 2008-07-21 |
| 1992914469 | Michelle Lindsay Smudde | Radiologic Technologist | 650 E. Indian School Road, Phoenix, AZ 85012-1892 | 2007-05-22 |
| 1225111438 | Eleni M Hatseras | Dietitian, Registered | 650 E. Indian School Road, Nutrition, Hospitality and Food Service-120, Phoenix, AZ 85012 | 2006-10-23 |
| 1114011541 | Ashley Bremer | Dietitian, Registered | 650 E. Indian School Road, Acs 11c-7, Phoenix, AZ 85012 | 2006-10-02 |
| 1184715864 | Irma E. Hernandez | Internal Medicine | 650 E. Indian School Road, Phoenix, AZ 85012 | 2006-09-27 |
| 1417979899 | Carl T. Hayden Va Medical Center | Military Hospital | 650 E. Indian School Road, Phoenix, AZ 85012 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819230 | Care On Pllc | Nurse Practitioner | 7171 S 51 Ave, Phoenix, AZ 85339-2923 | 2020-07-23 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1710522024 | Kelsey Conrad | Nurse Practitioner | 1 E Lexington Ave Unit 1602, Phoenix, AZ 85012-4203 | 2019-11-11 |
| 1124662408 | Rayiom Health and Wellness, Inc | Nurse Practitioner | 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 | 2019-10-30 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1598135741 | Sandra Shearer | Nurse Practitioner | 513 W Lavitt Ln, Phoenix, AZ 85086-6346 | 2015-09-30 |
| 1023499860 | Kelly Lynn Schultz | Nurse Practitioner | 3944 E Hillery Dr, Phoenix, AZ 85032-5245 | 2015-06-17 |
| 1609298900 | Lorna Ann Hill | Nurse Practitioner | 13224 N 31st Pl, Phoenix, AZ 85032-6041 | 2014-01-06 |
| 1801217765 | Trifit Pain Management LLC | Nurse Practitioner | 505 E Camelback Rd, Phoenix, AZ 85012-1615 | 2013-12-19 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.