Individual
MS. COLLEEN CHADDERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, MSN, CPNP
Contact information
Practice address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
(517) 780-9260
(517) 780-9263
Mailing address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
(517) 780-9260
(517) 780-9263
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704105291
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3200785-10
—
MI
01
—
Q04418
UPIN #
MI
Enumeration date
06/28/2005
Last updated
06/07/2011
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