Provider Demographics
NPI:1093405086
Name:COLLINS, SHIRLEY ANN (RN,WCC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN,WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 SW 140TH TER STE 170
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-5432
Mailing Address - Country:US
Mailing Address - Phone:877-281-1593
Mailing Address - Fax:352-354-1542
Practice Address - Street 1:414 SW 140TH TER STE 170
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-5432
Practice Address - Country:US
Practice Address - Phone:877-281-1593
Practice Address - Fax:352-354-1542
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9339472163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty