Provider Demographics
NPI:1528569530
Name:COLLIER, ALICIA (CRNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:CRNP
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 235
Mailing Address - Street 2:
Mailing Address - City:NAUVOO
Mailing Address - State:AL
Mailing Address - Zip Code:35578-0235
Mailing Address - Country:US
Mailing Address - Phone:205-471-9558
Mailing Address - Fax:
Practice Address - Street 1:2165 HIGHWAY 78 STE 100
Practice Address - Street 2:
Practice Address - City:DORA
Practice Address - State:AL
Practice Address - Zip Code:35062-4539
Practice Address - Country:US
Practice Address - Phone:205-648-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily