Provider Demographics
NPI:1760103360
Name:NAYLOR, COLLEEN (ABO LDO)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:ABO LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DUNER COURT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602
Mailing Address - Country:US
Mailing Address - Phone:540-327-1055
Mailing Address - Fax:
Practice Address - Street 1:1850 APPLE BLOSSUM DR.
Practice Address - Street 2:STE 105
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-662-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101003152156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician