Provider Demographics
NPI:1558923680
Name:BARTHOLOMEW, COLLEEN (DNP, APRN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:LEAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8303 DODGE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4108
Mailing Address - Country:US
Mailing Address - Phone:402-354-8124
Mailing Address - Fax:402-354-8127
Practice Address - Street 1:8303 DODGE ST STE 250
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4108
Practice Address - Country:US
Practice Address - Phone:402-354-8124
Practice Address - Fax:402-354-8127
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner