Provider Demographics
NPI:1538106000
Name:COLOMBEL, CECILIA ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:ANN
Last Name:COLOMBEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:CECILIA
Other - Middle Name:ANN
Other - Last Name:LENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:990 E SOUTH UNION AVE #31
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047
Mailing Address - Country:US
Mailing Address - Phone:801-759-2013
Mailing Address - Fax:
Practice Address - Street 1:7475 UNION PARK AVE
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1811
Practice Address - Country:US
Practice Address - Phone:801-566-2502
Practice Address - Fax:801-566-2535
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5886409-8900363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ8216Medicaid
NMS87272Medicare UPIN