Provider Demographics
NPI:1831574839
Name:COLBURN, COLETTE (NP)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:COLBURN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:
Other - Last Name:LAMBRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911244
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9397 CROWN CREST BLVD STE 420
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138
Practice Address - Country:US
Practice Address - Phone:303-770-0500
Practice Address - Fax:303-220-5053
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28196602A163W00000X
IN71005814A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201323600Medicaid
IN000000965023OtherANTHEM PROVIDER NUMBER
INP01629420Medicare PIN
IN000000965023OtherANTHEM PROVIDER NUMBER