Provider Demographics
NPI:1013679786
Name:COLLETON, KATRINA PRETRESE (RN)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:PRETRESE
Last Name:COLLETON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JANSEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3811
Mailing Address - Country:US
Mailing Address - Phone:845-255-0830
Mailing Address - Fax:845-255-0855
Practice Address - Street 1:1 JANSEN RD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3811
Practice Address - Country:US
Practice Address - Phone:845-255-0830
Practice Address - Fax:845-255-0855
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY794079-01163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation