Provider Demographics
NPI:1366634743
Name:COLLINS, KRISTA RENE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:RENE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23715 NE HIGHWAY 314
Mailing Address - Street 2:
Mailing Address - City:SALT SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32134-6239
Mailing Address - Country:US
Mailing Address - Phone:352-414-1644
Mailing Address - Fax:
Practice Address - Street 1:23715 NE HIGHWAY 314
Practice Address - Street 2:
Practice Address - City:SALT SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32134-6239
Practice Address - Country:US
Practice Address - Phone:352-414-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA152165363LA2200X, 363LW0102X
FLARNP 9395276363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIG771ZOtherMEDICARE
FL015690800Medicaid
FLM9KMXOtherBCBS