Provider Demographics
NPI:1053064832
Name:COLSON, BRANDY (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:COLSON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ANCHOR DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-3848
Mailing Address - Country:US
Mailing Address - Phone:207-301-5900
Mailing Address - Fax:
Practice Address - Street 1:15 ANCHOR DR STE 201
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-3848
Practice Address - Country:US
Practice Address - Phone:207-301-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP211668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily