Caroline Laetitia Colonna, DOM
Individual provider Active NPI Acupuncturist · El Prado, NM
NPI 1326100447 · NPPES record last updated Sep 29, 2010
Key facts
- NPI
- 1326100447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 526 (NM)
- Practice address
- 1103 Don Juan Valdez Lane
El Prado, NM 87529 - Phone
- (575) 758-5070
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 526 | NM | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 526 | NM | Yes |
Addresses
Primary practice location
1103 Don Juan Valdez Lane
El Prado, NM 87529
Mailing address
PO Box 3347
Taos, NM 87571
Phone (575) 758-5070
Other providers in El Prado, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2010. 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.