Provider Demographics
NPI:1437265337
Name:COLLINS, TONIA L (NP)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:L
Other - Last Name:CUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:710 N NILES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-1924
Mailing Address - Country:US
Mailing Address - Phone:574-647-1610
Mailing Address - Fax:
Practice Address - Street 1:500 ARCADE AVE STE 200
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2485
Practice Address - Country:US
Practice Address - Phone:574-294-8404
Practice Address - Fax:574-523-1642
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001888A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200967430Medicaid
INP01015517OtherRR MEDICARE
IN000000686460OtherBCBS ELKHART NEUROSURGERY
IN71001888AOtherNURSE PRACTITIONER
IN000000686460OtherBCBS BMG SB NEUROSURGERY
IN000000686460OtherBCBS BMG SB NEUROSURGERY