Provider Demographics
NPI:1437719143
Name:CODDINGTON, COLLEEN M (PMHNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:M
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:184 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-3515
Mailing Address - Country:US
Mailing Address - Phone:607-584-4465
Mailing Address - Fax:
Practice Address - Street 1:184 COURT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3515
Practice Address - Country:US
Practice Address - Phone:607-584-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY633040363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health