Provider Demographics
NPI:1508261504
Name:COLLINS, KERI ANN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:KERI
Other - Middle Name:ANN
Other - Last Name:GIELBUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 LAFFERTY AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-3684
Practice Address - Country:US
Practice Address - Phone:254-605-1100
Practice Address - Fax:254-605-1111
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730563363L00000X
TXAP126825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner