Individual
COLLEEN ANNE LINGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1050 N SAN FRANCISCO ST, SUITE B, FLAGSTAFF, AZ 86001-3259
(928) 214-3737
(928) 214-3837
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
961594
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447638
—
AZ
01
—
TAX ID
45-4464070
AZ
Enumeration date
07/16/2009
Last updated
03/20/2017
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