Provider Demographics
NPI:1639266919
Name:COLLINS, ANN MARIE (WHNP-C)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 W ORAIBI DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5503
Mailing Address - Country:US
Mailing Address - Phone:632-825-7647
Mailing Address - Fax:
Practice Address - Street 1:17612 N 59TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3795
Practice Address - Country:US
Practice Address - Phone:602-993-8636
Practice Address - Fax:602-993-2528
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN079115363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health