Provider Demographics
NPI:1629376017
Name:COLLISON, BARBARA (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:COLLISON
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 1:607 WOLVERINE DRIVE
Mailing Address - Street 2:#1073
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-1073
Mailing Address - Country:US
Mailing Address - Phone:907-442-7979
Mailing Address - Fax:907-442-7932
Practice Address - Street 1:607 WOLVERINE
Practice Address - Street 2:#1073
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-1073
Practice Address - Country:US
Practice Address - Phone:907-442-7979
Practice Address - Fax:907-442-7932
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator