Individual
MRS. SUSAN TINA COLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2 CORPORATION WAY STE 180, PEABODY, MA 01960-7996
(978) 573-4300
Mailing address
2 CORPORATION WAY STE 180, PEABODY, MA 01960-7996
(978) 573-4300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN279573
MA
363LF0000X
Family Nurse Practitioner
RN279573
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306161443
—
MA
Enumeration date
12/27/2017
Last updated
04/21/2022
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