Provider Demographics
NPI:1851322622
Name:COLBERT, NADINE V III (APRN)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:V
Last Name:COLBERT
Suffix:III
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:5026 WESCOE, MAIL STOP 2026
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6009
Mailing Address - Fax:913-588-8182
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:5026 WESCOE, MAIL STOP 2026
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6009
Practice Address - Fax:913-588-8182
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KSAPRN53-74601-021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424686400Medicaid
KS100332530AMedicaid
26575016OtherBCBS OF KANSAS CITY
S78162Medicare UPIN
KS0119811AMedicare ID - Type Unspecified