Provider Demographics
NPI:1578810487
Name:ATCHLEY, COLLEEN JANE (APRN)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:JANE
Last Name:ATCHLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 W STATE HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:RATCLIFF
Mailing Address - State:AR
Mailing Address - Zip Code:72951-9000
Mailing Address - Country:US
Mailing Address - Phone:479-431-2050
Mailing Address - Fax:479-431-2051
Practice Address - Street 1:9755 W STATE HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:RATCLIFF
Practice Address - State:AR
Practice Address - Zip Code:72951-9000
Practice Address - Country:US
Practice Address - Phone:479-431-2050
Practice Address - Fax:479-431-2051
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003744363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health