Individual
JODY L COLLETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
450 S KITSAP BLVD, PORT ORCHARD, WA 98366-3773
(360) 744-6275
Mailing address
450 S KITSAP BLVD, PORT ORCHARD, WA 98366-3773
(360) 744-6275
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30006898
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30006898
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046520
—
WA
Enumeration date
04/16/2007
Last updated
12/02/2020
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