Individual
MR. JEFFERY PAUL MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
9201 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-2468
(505) 298-2505
Mailing address
9201 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-2468
(505) 298-2505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP-00693
NM
363LP0200X
Pediatric Nurse Practitioner
Primary
R33523
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70526338
—
NM
Enumeration date
12/29/2006
Last updated
04/07/2021
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