Provider Demographics
NPI:1073300091
Name:SCHIESSL, COLIN (BSN, RN, CLC, IBCLC)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:
Last Name:SCHIESSL
Suffix:
Gender:
Credentials:BSN, RN, CLC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 KOHL ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2172
Mailing Address - Country:US
Mailing Address - Phone:402-770-0452
Mailing Address - Fax:
Practice Address - Street 1:200 KOHL ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2172
Practice Address - Country:US
Practice Address - Phone:402-770-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1631355163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant