Provider Demographics
NPI:1649928805
Name:TOMS, COLLEEN ALYSE (DNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ALYSE
Last Name:TOMS
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:ALYSE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:417 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-5368
Mailing Address - Country:US
Mailing Address - Phone:704-481-0171
Mailing Address - Fax:
Practice Address - Street 1:417 W WARREN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5368
Practice Address - Country:US
Practice Address - Phone:704-481-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily