Provider Demographics
NPI:1992504500
Name:COLLEY, ELIZABETH M JR
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:M
Last Name:COLLEY
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-2434
Mailing Address - Country:US
Mailing Address - Phone:402-314-4152
Mailing Address - Fax:
Practice Address - Street 1:2100 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-2434
Practice Address - Country:US
Practice Address - Phone:402-314-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider