Individual
CODY NICOLE COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PEDIATRICS
Contact information
Practice address
805 WASHINGTON BLVD S, LAUREL, MD 20707-4611
(443) 492-4000
Mailing address
127 N PATTERSON PARK AVE, BALTIMORE, MD 21231-1659
(443) 826-5850
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R213308
MD
Other
Enumeration date
11/06/2017
Last updated
03/17/2018
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