Provider Demographics
NPI:1821617994
Name:MEHAN, COLLEEN (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:MEHAN
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:PARISI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:246 OLD QUARRY CT
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5530
Mailing Address - Country:US
Mailing Address - Phone:609-932-2901
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST STE 205
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4426
Practice Address - Country:US
Practice Address - Phone:215-955-6835
Practice Address - Fax:215-923-5778
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN587878163W00000X
NJ26NR13098200163W00000X
DEL1-005869163W00000X
DELG-0001410363LF0000X
PASP021668363LF0000X
NJ26NJ01021700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse