Provider Demographics
NPI:1689005589
Name:COLLINS, SHONTA DENISE (CRNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:SHONTA
Middle Name:DENISE
Last Name:COLLINS
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Gender:F
Credentials:CRNP, FNP-C
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Mailing Address - Street 1:175 W COHAWKIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:CLARKSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08020-1145
Mailing Address - Country:US
Mailing Address - Phone:856-423-7700
Mailing Address - Fax:856-423-0823
Practice Address - Street 1:28 THROCKMORTON LN STE 204
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2558
Practice Address - Country:US
Practice Address - Phone:732-952-3999
Practice Address - Fax:732-952-8989
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2022-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP013482363LF0000X
NJ26NJ00487900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily