Provider Demographics
NPI:1275120743
Name:COLLINS, JULIE NICOLE (BSN RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 BUCKNER DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2407
Mailing Address - Country:US
Mailing Address - Phone:409-383-3069
Mailing Address - Fax:
Practice Address - Street 1:1813 BUCKNER DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2407
Practice Address - Country:US
Practice Address - Phone:409-383-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX746113163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse