Provider Demographics
NPI:1093085532
Name:COLBERT, DONNA RENEE (BA)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:RENEE
Last Name:COLBERT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 COURT ST STE B
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-6303
Mailing Address - Country:US
Mailing Address - Phone:918-310-0000
Mailing Address - Fax:
Practice Address - Street 1:436 COURT ST STE B
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-6303
Practice Address - Country:US
Practice Address - Phone:918-310-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator