CODY NICOLE COLLAZO (NPI# 1417460056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417460056 |
| Entity Type | Individual |
| Full Name | CODY NICOLE COLLAZO |
| Credential | CRNP-PEDIATRICS |
| Practice Address |
805 Washington Blvd S Laurel MD 20707-4611 |
| Mailing Address |
127 N Patterson Park Ave Baltimore MD 21231-1659 |
| Practice Telephone | 4434924000 |
| Mailing Telephone | 4438265850 |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R213308 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1803 York Rd, Lutherville Timonium, MD 210935119 | 4434924000 | |
| 6100 Dobbin Rd, Columbia, MD 210455804 | 4434924000 | |
| 7010 Ritchie Hwy, Glen Burnie, MD 210612902 | 4434924000 |
| Street Address |
805 WASHINGTON BLVD S |
| City | LAUREL |
| State | MD |
| Zip Code | 20707-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780944892 | Shamane I Onwudiachi | Physician Assistant | 805 Washington Blvd S, Laurel, MD 20707-4611 | 2012-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157156 | Mini'imah Wilson | Social Worker | 15041 Cherrywood Dr, Laurel, MD 20707 | 2020-08-31 |
| 1548893985 | Ernest Freeman | Clinic/Center | 367 Main St., Laurel, Laurel, MD 20707 | 2020-02-13 |
| 1538701859 | Family Health and Wellness Clinic LLC | Clinic/Center | 324 Main St. #523, Laurel, MD 20707 | 2019-10-09 |
| 1467018226 | Leena Daniel | Nurse Practitioner | 13 C Street, Suite D, Laurel, MD 20707 | 2019-05-16 |
| 1538723143 | Florence Okojie | Nurse Practitioner | 13 C St Ste G, Laurel, MD 20707 | 2019-04-29 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1043709637 | Bk Behavioral Health Center | Behavior Technician | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707 | 2018-05-09 |
| 1053800839 | Bk Behaviorial Health Center | Substance Abuse Rehabilitation Facility | 14300 Cherry Lane Court, Suite 202-203, Laurel, MD 20707 | 2018-05-07 |
| 1316435795 | Laurel Pharmacy II LLC | Pharmacy | 14402 Baltimore Ave, Laurel, MD 20707 | 2018-05-01 |
| Find all providers in zip 20707 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750366548 | Joan Loretta Macleod | Nurse Practitioner | 9811 Mallard Dr Ste 109, Laurel, MD 20708-3180 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405574 | Kylie White | Nurse Practitioner | 29595 Millstream Dr, Salisbury, MD 21804-2006 | 2020-10-23 |
| 1437764214 | Kelly Weaver | Nurse Practitioner | 11315 Pembroke Square, 110, Waldorf, MD 20603 | 2020-09-09 |
| 1003420282 | Mary Claire Perry | Nurse Practitioner | 737 W Lombard St Ste 314, Baltimore, MD 21201-1009 | 2020-09-03 |
| 1063022853 | Lauren Ranieri | Nurse Practitioner | 5301 Westbard Cir Ste 3, Bethesda, MD 20816-1463 | 2020-08-06 |
| 1841847209 | Brittany Nichole Frankel | Nurse Practitioner | 5870 Old Washington Rd, Sykesville, MD 21784-8622 | 2019-08-21 |
| 1912553595 | Kelsey Lynn Peifer | Nurse Practitioner | 6131 Baldridge Ter, Frederick, MD 21701-5858 | 2019-08-10 |
| 1841845351 | Advanced Practice Wellness, LLC | Nurse Practitioner | Washingtonian Blvd Ste 550, Gaithersburg, MD 20878 | 2019-08-02 |
| 1851946305 | Monica Patel | Nurse Practitioner | 3450 Old Washington Rd Ste 100, Waldorf, MD 20602-3249 | 2019-08-01 |
| 1922651082 | Deborah A Weber | Nurse Practitioner | 480 Lake Dr, Lusby, MD 20657-3260 | 2019-07-18 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.