Provider Demographics
NPI:1316186091
Name:COLLINS, MICHELLE D (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
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 1:1217 NW 79TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-6914
Mailing Address - Country:US
Mailing Address - Phone:503-740-3280
Mailing Address - Fax:
Practice Address - Street 1:1217 NW 79TH CIR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-6914
Practice Address - Country:US
Practice Address - Phone:503-740-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200940249RN163W00000X
WARN60071514163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse