Provider Demographics
NPI:1316201866
Name:WHEELER, COLETTE LYNN (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:LYNN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 N COTNER BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2344
Mailing Address - Country:US
Mailing Address - Phone:402-770-0522
Mailing Address - Fax:855-787-5418
Practice Address - Street 1:770 N COTNER BLVD
Practice Address - Street 2:STE 208
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2344
Practice Address - Country:US
Practice Address - Phone:402-489-3802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111358363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health