Stacie Colello
Individual provider Active NPI Registered Nurse · Springfield, GA
NPI 1104339811 · NPPES record last updated Nov 16, 2017
Key facts
- NPI
- 1104339811
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN175700 (GA)
- Practice address
- 802 Highway 119 South
Springfield, GA 31329 - Phone
- (912) 754-6484
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN175700 | GA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Effingham County Board of Health | Past | Accepting new patients | |
| Effingham County Board of Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN175700 | GA | Yes |
Addresses
Primary practice location
802 Highway 119 South
Springfield, GA 31329
Mailing address
3229 Ga Highway 119 N
Pembroke, GA 31321-5829
Other providers in Springfield, GA
- Burke Hospital Company
- Careplus Urgent Care, LLC
- Michael P Carter
- Chatham Orthopaedic Associates, PA
- Latronda Coble
- Curtis V. Cooper Primary Health Care Inc.
- Ashley Kessler Dasher
- Francisco Espirit De la Rosa
- Stephanie Mascarello Deloach
- Emilee Dodd
All providers in Springfield, GA · Registered Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.