Provider Demographics
NPI:1801195086
Name:NEWHALL, COLLEEN BURKE (MSN, NP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:BURKE
Last Name:NEWHALL
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 KARAM CT
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-5141
Mailing Address - Country:US
Mailing Address - Phone:949-910-0589
Mailing Address - Fax:
Practice Address - Street 1:28201 MARGUERITE PKWY STE 13
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3719
Practice Address - Country:US
Practice Address - Phone:949-364-3928
Practice Address - Fax:949-364-2297
Is Sole Proprietor?:No
Enumeration Date:2011-03-27
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20544363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health