Individual
FAITH COLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 862-1111
Mailing address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN598971
PA
367500000X
Certified Registered Nurse Anesthetist
700737
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9456662
FL
Other
Enumeration date
08/03/2015
Last updated
12/14/2021
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