Provider Demographics
NPI:1780816413
Name:COLLIER, SHIRLEY ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:ANN
Last Name:COLLIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 W PARK PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2027
Mailing Address - Country:US
Mailing Address - Phone:731-989-1007
Mailing Address - Fax:731-989-0704
Practice Address - Street 1:557 W PARK PL
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2027
Practice Address - Country:US
Practice Address - Phone:731-989-1007
Practice Address - Fax:731-989-0704
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN14873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN0000109336OtherREGISTERED NURSE
TNAPN14873OtherCAPN