Provider Demographics
NPI:1588324735
Name:COLLABORATIVE HEALTH
Entity type:Organization
Organization Name:COLLABORATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:NEGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-872-3800
Mailing Address - Street 1:304 MARCELLA RD STE A
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2578
Mailing Address - Country:US
Mailing Address - Phone:757-872-3800
Mailing Address - Fax:757-872-3808
Practice Address - Street 1:304 MARCELLA RD STE A
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2578
Practice Address - Country:US
Practice Address - Phone:757-872-3800
Practice Address - Fax:757-872-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty