Provider Demographics
NPI:1821281270
Name:BUCHANAN, COLLEEN NELSON (MS-CCC, SLP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:NELSON
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MS-CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13724 PEMBROKE CIR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-4202
Mailing Address - Country:US
Mailing Address - Phone:913-461-6757
Mailing Address - Fax:
Practice Address - Street 1:13724 PEMBROKE CIR
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-4202
Practice Address - Country:US
Practice Address - Phone:913-461-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1150235Z00000X
MSS-4875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist