Provider Demographics
NPI:1912900804
Name:COLIP, NANETTE C (MD)
Entity Type:Individual
Prefix:DR
First Name:NANETTE
Middle Name:C
Last Name:COLIP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 FORRESTAL DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-9662
Mailing Address - Country:US
Mailing Address - Phone:970-225-0875
Mailing Address - Fax:
Practice Address - Street 1:1332 FORRESTAL DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-9662
Practice Address - Country:US
Practice Address - Phone:970-225-0875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38717207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50904027Medicaid
H34361Medicare UPIN