Provider Demographics
NPI:1033311212
Name:COLLIER, JUDITH D (CRNA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:D
Last Name:COLLIER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7028
Mailing Address - Country:US
Mailing Address - Phone:205-902-7678
Mailing Address - Fax:205-380-9995
Practice Address - Street 1:318 N LAKE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7028
Practice Address - Country:US
Practice Address - Phone:205-902-7678
Practice Address - Fax:205-380-9995
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0122730367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered