Provider Demographics
NPI:1447601828
Name:COLLINGS, REBECCA (NP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:COLLINGS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11790 S NICKLAUS RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-5868
Mailing Address - Country:US
Mailing Address - Phone:801-673-0935
Mailing Address - Fax:
Practice Address - Street 1:11790 S NICKLAUS RD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-5868
Practice Address - Country:US
Practice Address - Phone:801-673-0935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT295455-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily