Provider Demographics
NPI:1376887679
Name:COLLINS, ASHLEY LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6301 S MCCLINTOCK DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3392
Mailing Address - Country:US
Mailing Address - Phone:480-214-2300
Mailing Address - Fax:480-214-2301
Practice Address - Street 1:60 S KYRENE RD
Practice Address - Street 2:STE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4685
Practice Address - Country:US
Practice Address - Phone:480-785-8700
Practice Address - Fax:480-785-8787
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2016-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COPA0003468363AM0700X
AZ5744363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ944616Medicaid