Jean Marie Colella, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP1972 Issued in AZ

Practice address

1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640

Phone

(928) 717-5232

Fax

(928) 717-5238

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Jean Marie Deffner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Cardiovascular Consultants LTD

  • Medical Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1023073525
  NPD (past)
• Laser Spine Institute of Arizona, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1174778484
  NPD (past)
• Aurora Medical Center Bay Area, Inc

  • Clinical Medical Laboratory
  • Marinette, WI
  • NPI 1083791115
  NPD (past)
• Laser Spine Institute, LLC

  • Specialist
  • Tampa, FL
  • NPI 1265483895
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1902803208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5987",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 GAIL GARDNER WAY STE 300",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051640",
            "telephone_number": "928-717-5232",
            "fax_number": "928-717-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLELLA",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN090566",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP1972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ NP LIC",
            "identifier": "AP1972",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "DEFFNER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittney Nicole Coahran, NP
• Anjaneane Love Coambs, M.ED., LPC AND IMHE
• April Marie Coates, APRN
• Darren L Coates, RPH
• Cognitive Function Development Institute, Inc.
• Jennifer Jaulane Coletta
• Colibri Counseling & Consulting, PLLC
• Colin Joseph Psychologist PHD PLLC
• Edward Allen Collacott, M.D
• Daniel John Collins, MD

• Adult Health Nurse Practitioner in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.