Provider Demographics
NPI:1578802229
Name:GARNEAU, COLLEEN JOAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:JOAN
Last Name:GARNEAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NORTHGATE ROAD
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6943
Mailing Address - Country:US
Mailing Address - Phone:267-991-7601
Mailing Address - Fax:267-991-7618
Practice Address - Street 1:2500 N GATE RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053
Practice Address - Country:US
Practice Address - Phone:267-991-7601
Practice Address - Fax:267-991-7618
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN272403L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse