Provider Demographics
NPI:1407124415
Name:COLLINGS, OLIVIA MILESHIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:MILESHIA
Last Name:COLLINGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130-24 150TH STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11436
Mailing Address - Country:US
Mailing Address - Phone:646-325-5017
Mailing Address - Fax:
Practice Address - Street 1:130-24 150TH STREET
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11436
Practice Address - Country:US
Practice Address - Phone:646-325-5017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 - 308346164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse