Provider Demographics
NPI:1114239142
Name:COLLINS, AUDREY J (GNP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:F
Credentials:GNP
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 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-561-0435
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-5057
Practice Address - Country:US
Practice Address - Phone:302-325-2309
Practice Address - Fax:302-325-6365
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELD0000141363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology