Provider Demographics
NPI:1275755142
Name:PINCH, COLLEEN MARIE (NP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARIE
Last Name:PINCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 NEW HAMPSHIRE AVE NW APT 210
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3238
Mailing Address - Country:US
Mailing Address - Phone:508-369-5610
Mailing Address - Fax:
Practice Address - Street 1:3020 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6865
Practice Address - Country:US
Practice Address - Phone:508-369-5610
Practice Address - Fax:415-796-3841
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208476363LF0000X
CA95013653363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily