Individual provider Active NPI

Colleen K Del Fava, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brown Deer, WI
National Provider Identifier
1740994292
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13528-33 Issued in WI
Practice address
4555 W Schroeder Dr
Brown Deer, WI 53223-1475
Phone
(414) 355-9000
NPI assigned
Jan 10, 2023
Last updated
Jun 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 174832-030 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13528-33 WI Primary

Addresses

Primary practice location

4555 W Schroeder Dr
Brown Deer, WI 53223-1475

Mailing address

34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411

Other names 1

  • Colleen Mulcahy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307000657 WI Practitioner - Nurse Practitioner 1456724772 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
174832-030WIMDRegistered Nurse
13528-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Mar 1, 2023 Accepting new patients

Locations

4555 W Schroeder Dr
Milwaukee, WI 53223
Phone (414) 355-9000

4600 W Schroeder Dr
Milwaukee, WI 53223
Phone (414) 355-9000

34700 Valley Rd
Oconomowoc, WI 53066

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1740994292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532231475",
            "telephone_number": "414-355-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL FAVA",
        "first_name": "COLLEEN",
        "middle_name": "K",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "174832-030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13528-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MULCAHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brown Deer, WI

Sources for this page

Verify at the official NPI Registry.