Colleen Megan Canavan

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

RN2344154 Issued in MA

Practice address

130 Second Ave
Waltham, MA 02451-1158

Phone

(781) 434-6500

NPI assigned

Apr 14, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1225971070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 GUERNSEY ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312316",
            "telephone_number": "978-831-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SECOND AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511158",
            "telephone_number": "781-434-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Liberty Sq Fl 9",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021094825",
            "country_code": "US",
            "telephone_number": "857-244-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "COLLEEN",
        "middle_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MA",
            "license": "RN2344154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophronia G Camp, MSW, LCSW
• Amy Campbell, R.D.
• Irene Ganssle Campbell, NP
• Jillian Campbell, MSW, LCSW
• Todd Campbell, PT
• William Chase Cannon
• Marie Cantone, M.S. CCC-SLP
• Sarah Cantor
• Yili Cao, YILI CAO
• Olivia Caplan, PT, DPT

• Obstetrics & Gynecology Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.