Provider Demographics
NPI:1639628456
Name:COLLINS, EVA-LORENA (FNP)
Entity Type:Individual
Prefix:MS
First Name:EVA-LORENA
Middle Name:
Last Name:COLLINS
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 1:3366 N FORGEUS AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1164
Mailing Address - Country:US
Mailing Address - Phone:520-250-4870
Mailing Address - Fax:
Practice Address - Street 1:450 W PSO. REDANDO
Practice Address - Street 2:EL RIO COMMUNITY HEALTH CENTER
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-8253
Practice Address - Country:US
Practice Address - Phone:520-205-4904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily