Individual
COLEEN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
672 SW PRIMA VISTA BLVD STE 102, PORT ST LUCIE, FL 34983-1820
(772) 905-2560
(772) 336-8341
Mailing address
2313 SW 18TH TER, CAPE CORAL, FL 33991-3058
(814) 644-8299
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11014451
FL
Other
Enumeration date
07/22/2021
Last updated
12/22/2022
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