MS. CONNIE MALLO RANDAZZO


Address: 2620 E Prospect Rd, Suite 190, Fort Collins, CO 80525-9098
Phone: 9702211106

MS. CONNIE MALLO RANDAZZO (NPI# 1871602664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871602664
Entity Type Individual
Full Name MS. CONNIE MALLO RANDAZZO
Other Name CONNIE F MALLO
Credential CNS
Practice Address 2620 E Prospect Rd
Suite 190
Fort Collins
CO 80525-9098
Practice Telephone 9702211106
Practice Fax Number 9702321050
Mailing Telephone 9702211106
Mailing Fax Number 9702321050
Enumeration Date 2006-08-29
Last Update Date 2016-05-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364SP0808X Clinical Nurse Specialist
Specialization: Psych/Mental Health
81170 CO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO 87954770 05

Office Location

Street Address 2620 E PROSPECT RD
SUITE 190
City FORT COLLINS
State CO
Zip Code 80525-9098

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154609329 Integrative Health Consulting Family Medicine 2620 E Prospect Rd, Suite 190, Fort Collins, CO 80525-9098 2011-07-21
1962793232 Brooke Patricia Schneider Psychiatry & Neurology 2620 E Prospect Rd, Fort Collins, CO 80525-9098 2011-04-21
1528373933 Cori Ann Ramirez Psychologist 2620 E Prospect Rd, Suite 190, Fort Collins, CO 80525-9098 2010-08-10
1003142589 Steven P Rondeau Naturopath 2620 E Prospect Rd, Suite# 190, Fort Collins, CO 80525-9098 2009-10-19
1386970861 Mary F Rondeau Naturopath 2620 E Prospect Rd, Suite 190, Fort Collins, CO 80525-9098 2009-10-19
1154515534 Eleanor Hickerson Physical Therapist 2620 E Prospect Rd, Suite 160, Fort Collins, CO 80525-9098 2007-08-29
1386850915 Keith A Meier Nurse Practitioner 2620 E Prospect Rd, Suite 160, Fort Collins, CO 80525-9098 2007-05-14
1003931536 Bonnie L Downey Physical Therapist 2620 E Prospect Rd, Suite 160, Fort Collins, CO 80525-9098 2007-03-21
1568588945 Laurie Johnson Physical Therapist 2620 E Prospect Rd, Ste 160, Fort Collins, CO 80525-9098 2007-03-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356950299 Kelly Westbrook Schmalstich Clinical Nurse Specialist 2020 Blue Yonder Way, Fort Collins, CO 80525 2020-07-27
1912522376 Tender Gifts Midwifery and Birth Center Clinical Nurse Specialist 1817 Jessup Dr Farms, Fort Collins, CO 80525 2020-06-11
1114566015 Andrea Nicole Brogdon Acupuncturist 2501 S. College Ave, Fort Collins, CO 80525 2019-12-26
1013553593 Kids Overcoming, LLC Home Health 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 2019-11-20
1568019966 Julia Heithoff Behavioral Analyst 1100 Haxton Dr #115, Fort Collins, CO 80525 2019-08-20
1144875246 Harmony Smiles Dentistry, LLP Dentist 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 2019-08-06
1841774502 Shannon L Harris Social Worker 305 Carpenter Road, Fort Collins, CO 80525 2018-09-19
1306332101 Joshua Evans Brooks Optometrist 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 2018-07-03
1285120212 Danae Fuqua Physical Medicine & Rehabilitation Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 2018-07-02
1528552890 Megan E Locke Audiologist 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 2018-06-19
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Taxonomy Information

Taxonomy Code 364SP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1760596852 Linda Perrin Clinical Nurse Specialist 1217 Riverside Ave, Fort Collins, CO 80524-3218 2006-08-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346369931 Wayne Thrash Clinical Nurse Specialist 2662 Curtis St, Denver, CO 80205-2634 2007-03-28
1982755351 Pamela Ann Bricker Clinical Nurse Specialist 730 Cheyenne Blvd # 300, Colorado Springs, CO 80905-2423 2007-01-14
1225186323 Laura R Mehringer Clinical Nurse Specialist 7000 Broadway, Ste 210, Denver, CO 80221-2910 2007-01-08
1265478630 Rebecca Ann Howard Clinical Nurse Specialist 2200 W Berry Ave, Arapahoe/douglas Mental Health Network, Littleton, CO 80120-1101 2006-06-22
1992779805 Carole M Crawford Clinical Nurse Specialist 63 E Spaulding Ave, Pueblo West, CO 81007-5416 2006-02-15
1407836679 Debora Kay Arrera Clinical Nurse Specialist 10350 Dransfeldt Rd, Parker, CO 80134-9673 2006-01-21
1679112205 Abbigail Victoria Sidwell Clinical Nurse Specialist 4141 E Dickenson Pl, Denver, CO 80222-6012 2019-12-30
1841722030 Sher Lynn Sauve'-demos Clinical Nurse Specialist 2121 S Oneida St, Suite 220, Denver, CO 80224-2549 2017-03-28
1396026407 Carolyn Dacres, Rxs, LLC Clinical Nurse Specialist 4155 E Jewell Ave Ste 225, Denver, CO 80222-4506 2011-09-01
1457546814 Michael James Dougherty Clinical Nurse Specialist 3400 Lutheran Pkwy, Wheat Ridge, CO 80033-6035 2007-09-10
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Competitor

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City FORT COLLINS
Zip Code 80525

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Dataset Information

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.

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