Provider Demographics
NPI:1679983027
Name:COLLIER, EDWARD ALLEN II (CNP)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ALLEN
Last Name:COLLIER
Suffix:II
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 TEUTON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4123
Mailing Address - Country:US
Mailing Address - Phone:504-327-5857
Mailing Address - Fax:504-324-3569
Practice Address - Street 1:4213 TEUTON ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4123
Practice Address - Country:US
Practice Address - Phone:504-327-5857
Practice Address - Fax:504-324-3569
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN347183163W00000X
FLARNP9441584363LA2100X
OHCOA.16306-NP363LA2100X
LA219028363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019294400Medicaid
FL019294400Medicaid
FL019294400Medicaid