Provider Demographics
NPI:1477924587
Name:ELENA COLLIER
Entity Type:Organization
Organization Name:ELENA COLLIER
Other - Org Name:COLLIER EYECARE, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-438-6322
Mailing Address - Street 1:1101 FOREST RETREAT RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2272
Mailing Address - Country:US
Mailing Address - Phone:615-379-9881
Mailing Address - Fax:615-581-1928
Practice Address - Street 1:1101 FOREST RETREAT RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2272
Practice Address - Country:US
Practice Address - Phone:615-379-9881
Practice Address - Fax:615-581-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2848152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ016936Medicaid
TNQ018929Medicaid