Provider Demographics
NPI:1437328937
Name:COLLINS, PATRICIA (CNM,NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CNM,NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM,NP
Mailing Address - Street 1:3231 SE 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2248
Mailing Address - Country:US
Mailing Address - Phone:503-775-4931
Mailing Address - Fax:503-788-7285
Practice Address - Street 1:3231 SE 50TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-2248
Practice Address - Country:US
Practice Address - Phone:503-775-4931
Practice Address - Fax:503-788-7285
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR105755363LX0001X, 363LP1700X
GA10253367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal