Provider Demographics
NPI:1033586615
Name:COLLINS, NANCY DANIELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:DANIELLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31534-1377
Mailing Address - Country:US
Mailing Address - Phone:912-389-2231
Mailing Address - Fax:912-384-1470
Practice Address - Street 1:903 WARD ST W STE B
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-3536
Practice Address - Country:US
Practice Address - Phone:912-384-4111
Practice Address - Fax:912-384-4117
Is Sole Proprietor?:No
Enumeration Date:2015-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003170214FMedicaid
GA003170214FMedicaid