Provider Demographics
NPI:1770702664
Name:RIES, COLLEEN MARIE (RN, BSN)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARIE
Last Name:RIES
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5253
Mailing Address - Country:US
Mailing Address - Phone:970-223-3730
Mailing Address - Fax:
Practice Address - Street 1:COLORADO STATE UNIVERSITY
Practice Address - Street 2:HARTSHORN HEALTH SERVICE
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-0001
Practice Address - Country:US
Practice Address - Phone:970-491-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120054163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health