Provider Demographics
NPI:1306185962
Name:COLBERT, ALLISON LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:LOUISE
Last Name:COLBERT
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 1:80 CONGRESS ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3564
Mailing Address - Country:US
Mailing Address - Phone:413-739-1611
Mailing Address - Fax:413-739-1711
Practice Address - Street 1:80 CONGRESS ST
Practice Address - Street 2:SUITE 106
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3564
Practice Address - Country:US
Practice Address - Phone:413-739-1611
Practice Address - Fax:413-739-1711
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN257070363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner