Provider Demographics
NPI:1518614577
Name:COLLINS, MEAGHN MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:MEAGHN
Middle Name:MICHELLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
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 2042
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32170-2042
Mailing Address - Country:US
Mailing Address - Phone:765-419-5052
Mailing Address - Fax:
Practice Address - Street 1:90 CEDAR DUNES DR
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-3861
Practice Address - Country:US
Practice Address - Phone:765-419-5052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNURRNLIC143119163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse