Provider Demographics
NPI:1538855184
Name:HOLLINGSWORTH, COLETTE
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 S MILLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-1720
Mailing Address - Country:US
Mailing Address - Phone:321-652-7508
Mailing Address - Fax:
Practice Address - Street 1:128 S MILLBROOK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80018-1720
Practice Address - Country:US
Practice Address - Phone:321-652-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1626840163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care