Provider Demographics
NPI:1275957185
Name:COLLINS-PICKETT, TONYA RENEE (APRN,FNP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:RENEE
Last Name:COLLINS-PICKETT
Suffix:
Gender:F
Credentials:APRN,FNP
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:ACKLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34290 FORD RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3051
Mailing Address - Country:US
Mailing Address - Phone:313-516-3142
Mailing Address - Fax:
Practice Address - Street 1:34290 FORD RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3051
Practice Address - Country:US
Practice Address - Phone:313-516-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704288991163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse