Provider Demographics
NPI:1225329212
Name:COLLINS, LORRAINE MICHELL (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:MICHELL
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 E 110TH ST.
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104
Mailing Address - Country:US
Mailing Address - Phone:216-386-5098
Mailing Address - Fax:
Practice Address - Street 1:3435 E 110TH ST.
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104
Practice Address - Country:US
Practice Address - Phone:216-386-5098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN222631163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse