Provider Demographics
NPI:1174287874
Name:COLLINS, JUDITH (NP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:BUXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:8600 QUIOCCASIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5514
Mailing Address - Country:US
Mailing Address - Phone:804-655-2794
Mailing Address - Fax:804-622-0804
Practice Address - Street 1:108 COWARDIN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2020
Practice Address - Country:US
Practice Address - Phone:804-655-2794
Practice Address - Fax:804-622-0804
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024037630363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health