Provider Demographics
NPI:1811088768
Name:MORREY, COLLEEN JULIE (NP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:JULIE
Last Name:MORREY
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 1:3620 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6631
Mailing Address - Country:US
Mailing Address - Phone:719-325-0342
Mailing Address - Fax:
Practice Address - Street 1:30 S NEVADA AVE
Practice Address - Street 2:CITY EMPLOYEE CLINIC
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1802
Practice Address - Country:US
Practice Address - Phone:719-385-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30148363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34380353Medicaid
COF24489Medicare UPIN