Provider Demographics
NPI:1881807212
Name:COLELLA, CONSTANCE ANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:ANN
Last Name:COLELLA
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 COBBLESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-3901
Mailing Address - Country:US
Mailing Address - Phone:973-477-7307
Mailing Address - Fax:973-844-4972
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2466
Practice Address - Fax:973-844-4972
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC07152000364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNC71520OtherAPRN LICENSE
NJNC71520OtherAPRN LICENSE