Provider Demographics
NPI:1437620200
Name:COLLINS, SIMONE V (APRN)
Entity Type:Individual
Prefix:MS
First Name:SIMONE
Middle Name:V
Last Name: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 1:937 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-2347
Mailing Address - Country:US
Mailing Address - Phone:718-260-2900
Mailing Address - Fax:
Practice Address - Street 1:6010 BAY PKWY STE 901
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6081
Practice Address - Country:US
Practice Address - Phone:718-238-2100
Practice Address - Fax:718-475-1821
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00877700363L00000X
NY636838-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner