Mary Bourne Collo, ANP05/

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN018619 Issued in AZ

Practice address

650 E. Indian School Road
Research Service
Phoenix, AZ 85012-1892

Phone

(602) 277-5551

Fax

(602) 212-2097

NPI assigned

Jun 27, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932136728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 E MARSHALL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142358",
            "telephone_number": "602-230-9336",
            "fax_number": "602-277-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E. INDIAN SCHOOL ROAD",
            "address_2": "RESEARCH SERVICE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121892",
            "telephone_number": "602-277-5551",
            "fax_number": "602-212-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLO",
        "first_name": "MARY",
        "middle_name": "BOURNE",
        "name_prefix": "Ms.",
        "credential": "ANP05/",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN018619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Collins, MD
• Tricha Collinson, RN
• Leah Marie Collison, OD
• Robert M Collison, RD, CDE
• Luis C Collo Jr., M.D.
• Christopher J Colloca, D.C.
• Troy Derek Collon, PA-C
• Elizabeth Collyer, MD
• Bina Colman
• Colmed Laboratories & Radiology

• Adult Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, 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 Jul 8, 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.