Randazzo, Connie Mallo
Randazzo, Connie Mallo is an individual health care provider with primary practice located at 2620 E Prospect Rd Suite 190, Fort Collins CO 80525-9098. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Randazzo, Connie Mallo can be contacted via phone (970) 221-1106.Contact Information
Primary practice address
2620 E Prospect Rd Suite 190
Fort Collins CO 80525-9098
Phone: (970) 221-1106
Fax: (970) 232-1050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 364SP0808X | 81170 | Colorado |
Profile Details
| NPI number | 1871602664 |
|---|---|
| LBN Legal business name | Randazzo, Connie Mallo |
| Credentials | Clinical Nurse Specialist (CNS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | May 26th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871602664 | NPPES |
| Colorado | MEDICAID | 87954770 |
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