Provider Demographics
NPI:1750133559
Name:COLLEY, MICHELLE LEE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:COLLEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FORSYTHE RD
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1119
Mailing Address - Country:US
Mailing Address - Phone:412-918-8008
Mailing Address - Fax:
Practice Address - Street 1:1 FORSYTHE RD
Practice Address - Street 2:
Practice Address - City:PRESTO
Practice Address - State:PA
Practice Address - Zip Code:15142-1119
Practice Address - Country:US
Practice Address - Phone:740-968-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029306363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health