Provider Demographics
NPI:1518853001
Name:IMBRAGLIO, COLLEEN NMN
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:NMN
Last Name:IMBRAGLIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 ROPER NORTH FORK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4233
Mailing Address - Country:US
Mailing Address - Phone:301-573-2599
Mailing Address - Fax:
Practice Address - Street 1:1337 ROPER NORTH FORK RD
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4233
Practice Address - Country:US
Practice Address - Phone:301-573-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant