Provider Demographics
NPI:1417212630
Name:COLINO, RACHEL A (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:COLINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HERKIMER RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-2311
Mailing Address - Country:US
Mailing Address - Phone:315-724-6144
Mailing Address - Fax:315-724-3978
Practice Address - Street 1:101 HERKIMER RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-724-6144
Practice Address - Fax:315-724-3978
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337373363LF0000X
NYF337373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily