Individual
COLIN JUDE MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
300 S 6TH ST, WILLIAMS, AZ 86046-0110
(928) 635-4441
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
272689
GA
363LF0000X
Family Nurse Practitioner
Primary
229212
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
N/A
—
Enumeration date
06/04/2019
Last updated
01/27/2021
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