Provider Demographics
NPI:1598168676
Name:COLLEY, CATHERINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:COLLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 88TH AVE W
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-7637
Mailing Address - Country:US
Mailing Address - Phone:130-971-6732
Mailing Address - Fax:
Practice Address - Street 1:3618 N DIVISION ST STE 202
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-5403
Practice Address - Country:US
Practice Address - Phone:309-716-7329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA75299363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant