Provider Demographics
NPI:1437470291
Name:COLLETT, ANNE MARIE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:COLLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:FRASURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-0568
Mailing Address - Country:US
Mailing Address - Phone:606-528-7010
Mailing Address - Fax:
Practice Address - Street 1:1203 AMERICAN GREETING CARD RD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4811
Practice Address - Country:US
Practice Address - Phone:606-528-7010
Practice Address - Fax:606-528-5401
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1165169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse