Provider Demographics
NPI:1356302954
Name:SCOTT-COLLINS, DONCHELLE DENISE (DNP, CRNP)
Entity Type:Individual
Prefix:DR
First Name:DONCHELLE
Middle Name:DENISE
Last Name:SCOTT-COLLINS
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3317
Mailing Address - Country:US
Mailing Address - Phone:205-933-8101
Mailing Address - Fax:
Practice Address - Street 1:24515 7TH AVE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35071
Practice Address - Country:US
Practice Address - Phone:205-933-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051528064Medicaid
ALQ52122Medicare UPIN
AL051528064COLMedicare ID - Type Unspecified