Provider Demographics
NPI:1760721120
Name:COLLIER, NATALIE ROSE (PMHNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ROSE
Other - Last Name:TOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:26250 N 46TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8510
Mailing Address - Country:US
Mailing Address - Phone:602-892-0915
Mailing Address - Fax:
Practice Address - Street 1:15256 N 75TH AVE
Practice Address - Street 2:STE 360
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4760
Practice Address - Country:US
Practice Address - Phone:623-486-2424
Practice Address - Fax:623-486-4324
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4784363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily