Provider Demographics
NPI:1598328395
Name:SPRATT, COLLEEN HEATHER (NP, DNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:HEATHER
Last Name:SPRATT
Suffix:
Gender:F
Credentials:NP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 5TH AVE RM 300
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7708
Mailing Address - Country:US
Mailing Address - Phone:646-832-2238
Mailing Address - Fax:415-367-3629
Practice Address - Street 1:220 5TH AVE RM 300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7708
Practice Address - Country:US
Practice Address - Phone:646-832-2238
Practice Address - Fax:415-367-3629
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740050-1163WP0808X
NYF402643-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health