Basic Information
Provider Information
NPI: 1861032583
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COLSON
FirstName: CELIA
MiddleName: DANIELLE
NamePrefix: DR.
NameSuffix:  
Credential: DNP, APRN, PMHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 529 NW 60TH ST
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326072008
CountryCode: US
TelephoneNumber: 3523315100
FaxNumber: 3523329607
Practice Location
Address1: 529 NW 60TH ST
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326072008
CountryCode: US
TelephoneNumber: 3523315100
FaxNumber: 3523329607
Other Information
ProviderEnumerationDate: 01/10/2020
LastUpdateDate: 01/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAPRN11005334FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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