Provider Demographics
NPI:1396011813
Name:PIRILLO-COLLINS, MARIE V (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:V
Last Name:PIRILLO-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 1:17621 LEDGER LINE LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5621
Mailing Address - Country:US
Mailing Address - Phone:386-864-1641
Mailing Address - Fax:
Practice Address - Street 1:17621 LEDGER LINE LN
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5621
Practice Address - Country:US
Practice Address - Phone:386-864-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP-9268967363LF0000X
FLAPRN9268967363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1396011813OtherNPI