Provider Demographics
NPI:1609026392
Name:COLOBONG, JOYCE VENERACION (NP)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:VENERACION
Last Name:COLOBONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8260 WILLOW OAKS CORPORATE DR STE 650
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4531
Practice Address - Country:US
Practice Address - Phone:703-776-2000
Practice Address - Fax:571-665-6797
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2022-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024181392363L00000X
CA521228363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care