Provider Demographics
NPI:1497008585
Name:SILK, COLLEEN M (FNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:SILK
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 1:421 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5357
Mailing Address - Country:US
Mailing Address - Phone:215-750-1633
Mailing Address - Fax:
Practice Address - Street 1:1609 WOODBOURNE RD STE 101
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1520
Practice Address - Country:US
Practice Address - Phone:215-945-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily