Doctor Name: | KELLY ANN COLOFF |
NPI Number: | 1205094398 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 28746 |
Business Practice Address: | 734 9th St W Ste 12 Columbia Falls, MT - 599123858 |
Business Phone Number: | 4068921011 |
Business Fax Number: | |
Mailing Address: | 734 9th St W Ste 12, COLUMBIA FALLS |
State: | MT |
Postal Code: | 599123858 |
Phone Number: | 4068921011 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2008 |
NPI Last Update Date: | 04/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 28746 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |