Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.020167 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.020167 | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.020167 | OH |
NPI | 1083146336 |
---|---|
Provider Name | Joshua Adam Colla |
First Address | Cincinnati, OH 45212-2198 |
Second Address | Cincinnati, OH 45212-2198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 12/05/2017 |