Provider Demographics
NPI:1568503910
Name:KOLLAR, MARY FLEMING (FNP)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:FLEMING
Last Name:KOLLAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 CHEROKEE BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-2217
Mailing Address - Country:US
Mailing Address - Phone:865-250-1521
Mailing Address - Fax:
Practice Address - Street 1:VINE MIDDLE SCHOOL CLINIC
Practice Address - Street 2:1807 MARTIN LUTHER KING AVENUE
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37915
Practice Address - Country:US
Practice Address - Phone:865-594-5078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13477390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program