Provider Demographics
NPI:1356667927
Name:COLLINS, COLLEEN O (ARNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:O
Last Name:COLLINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:O
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1290 GOLFVIEW AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6740
Mailing Address - Country:US
Mailing Address - Phone:863-519-7900
Mailing Address - Fax:863-519-7696
Practice Address - Street 1:1021 LAKELAND HILLS BOULEVARD
Practice Address - Street 2:LAKELAND VOLUNTEERS IN MEDICINE
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805
Practice Address - Country:US
Practice Address - Phone:863-688-5846
Practice Address - Fax:863-802-4640
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9167802363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health