Provider Demographics
NPI:1437672680
Name:COLAO, DEIRDRE BRIDGET (DNP, FNP - C)
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:BRIDGET
Last Name:COLAO
Suffix:
Gender:F
Credentials:DNP, FNP - C
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:BRIDGET
Other - Last Name:O' CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 W KALER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7241
Mailing Address - Country:US
Mailing Address - Phone:602-370-8328
Mailing Address - Fax:
Practice Address - Street 1:4611 E SHEA BLVD STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4255
Practice Address - Country:US
Practice Address - Phone:602-441-3845
Practice Address - Fax:602-464-9769
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily