Kathleen Ann McCollum, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

025557 Issued in AZ

Practice address

1025 N Country Club Dr
Mesa, AZ 85201-3307

Phone

(480) 472-0562

Fax

(480) 472-0796

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Kathleen Younglund McCollum Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487785846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013307",
            "telephone_number": "480-472-0562",
            "fax_number": "480-472-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013307",
            "telephone_number": "480-472-0562",
            "fax_number": "480-472-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "025557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "648230",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MCCOLLUM",
            "middle_name": "YOUNGLUND",
            "prefix": "MRS.",
            "credential": "R.N.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Matthew Henry McClement, DMD
• Rebecca McClintic, DPT
• Noel June Fernandez McCluney, PT, DPT
• Jason McClure
• Rebecca L McCollaum, A.P.R.N.
• Rithirat John McCollum, COTA
• Renae McCombs, CPNP-AC
• Susan Marie McConnell, PHARMD
• David Fairbanks McCook, D.D.S.
• Cari McCormick, LAC

• Registered Nurse in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.