Provider Demographics
NPI:1477551919
Name:COLLINS, BEVERLY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2570
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2570
Mailing Address - Country:US
Mailing Address - Phone:828-693-4431
Mailing Address - Fax:828-693-4434
Practice Address - Street 1:510 BALSAM RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5703
Practice Address - Country:US
Practice Address - Phone:828-693-4431
Practice Address - Fax:828-693-4431
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0006-00107363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
500010194OtherRAILROAD MEDICARE B
500010194OtherRAILROAD MEDICARE B
S93035Medicare UPIN