Provider Demographics
NPI:1942286422
Name:BYRNES, COLLEEN BRIDGET (ARNP)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:BRIDGET
Last Name:BYRNES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:OSAGE
Mailing Address - State:IA
Mailing Address - Zip Code:50461-1456
Mailing Address - Country:US
Mailing Address - Phone:641-732-6100
Mailing Address - Fax:641-732-6108
Practice Address - Street 1:620 N 8TH ST
Practice Address - Street 2:
Practice Address - City:OSAGE
Practice Address - State:IA
Practice Address - Zip Code:50461-1456
Practice Address - Country:US
Practice Address - Phone:641-732-6100
Practice Address - Fax:641-732-6108
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR157495-9363L00000X
IAA099600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500027206OtherMEDICARE RAILROAD
IAP69460Medicare UPIN
MN500002119Medicare ID - Type Unspecified
MNP69460Medicare UPIN
MN345898900Medicare ID - Type Unspecified