Connie Mallo Randazzo, CNS

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

81170 Issued in CO

Practice address

2620 E Prospect Rd
Suite 190
Fort Collins, CO 80525-9098

Phone

(970) 221-1106

Fax

(970) 232-1050

NPI assigned

Aug 29, 2006

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

Other identifiers 1

Other names 1

• Connie F Mallo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1871602664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E PROSPECT RD",
            "address_2": "SUITE 190",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259098",
            "telephone_number": "970-221-1106",
            "fax_number": "970-232-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 E PROSPECT RD",
            "address_2": "SUITE 190",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259098",
            "telephone_number": "970-221-1106",
            "fax_number": "970-232-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAZZO",
        "first_name": "CONNIE",
        "middle_name": "MALLO",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CO",
            "license": "81170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87954770",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "MALLO",
            "middle_name": "F",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Ramsey, LPCC
• Brooke Ranallo
• Gary Stanley Ranch, PSY.D.
• Rand-Scot, Inc
• Robyn S Randall, MD
• Jake Randolph, IOMT
• Julia Rank
• Rachel Kristine Rantanen I, DPT
• Analeese Rapagnani
• Melanie Deniz Rapp

• Psychiatric/Mental Health Clinical Nurse Specialist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.