Provider Demographics
NPI:1497208425
Name:COLLIER, JENNIFER DOROTHY (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DOROTHY
Last Name:COLLIER
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 1:26051 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-9543
Mailing Address - Country:US
Mailing Address - Phone:517-499-9133
Mailing Address - Fax:
Practice Address - Street 1:139 W MANSION ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1119
Practice Address - Country:US
Practice Address - Phone:269-248-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704216562363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care