Provider Demographics
NPI:1063274330
Name:COLICA, CHRISTINA (MSN, APRN,WHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COLICA
Suffix:
Gender:F
Credentials:MSN, APRN,WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171A SPARTA WAY UNIT A
Mailing Address - Street 2:
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505-1020
Mailing Address - Country:US
Mailing Address - Phone:954-661-6855
Mailing Address - Fax:
Practice Address - Street 1:171A SPARTA WAY UNIT A
Practice Address - Street 2:
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99505-1020
Practice Address - Country:US
Practice Address - Phone:954-661-6855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK208453363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health