Linda Marie Colliflower, RNC,NP
Individual provider Active NPI Nurse Practitioner · Jackson, CA
NPI 1265670384 · NPPES record last updated Aug 15, 2025
Key facts
- NPI
- 1265670384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1622 (CA)
- Practice address
- 12140 New York Ranch Rd
Jackson, CA 95642-9407 - Phone
- (209) 257-2400
- NPI assigned
- Jan 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231229002127 | CA | Order and Referring Only - Obstetrics/Gynecology |
2769832922 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1622 | CA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M a C T Health Board Incorporated | Past | Accepting new patients |
Interoperability endpoints
- linda.colliflower.p1@direct.macthealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 1622 | CA | |
| Nurse Practitioner | 363L00000X | 1622 | CA | Yes |
Addresses
Primary practice location
12140 New York Ranch Rd
Jackson, CA 95642-9407
Mailing address
817 Court St
#8
Jackson, CA 95642-2156
Phone (209) 223-1031
Other practice location 1
817 Court St
#8
Jackson, CA 95642-2156
Phone (209) 223-1031
Other providers in Jackson, CA
- Tyler Chavez
- Chelsea Yule Solutions
- Bradford J. Chew
- Christopher Sienes Chiropractic Corporation
- Rachel F Clay
- Common Ground Senior Services
- County of Amador
- Suzan E. Cowan
- Thomas Cowgill
- Erin Cox
All providers in Jackson, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.