Provider Demographics
NPI:1467020339
Name:COLLINS, CHIQUITA (PMHNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:CHIQUITA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 DILIGENCE DR STE 227
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4211
Mailing Address - Country:US
Mailing Address - Phone:757-933-5386
Mailing Address - Fax:757-210-4197
Practice Address - Street 1:825 DILIGENCE DR STE 227
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4211
Practice Address - Country:US
Practice Address - Phone:757-933-5386
Practice Address - Fax:757-210-4197
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181629363LP0808X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No171W00000XOther Service ProvidersContractor