Provider Demographics
NPI:1790035863
Name:COLLINS, DONNA CHERYLL (FNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:CHERYLL
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 1:4400 RIDGEFIELD WAY
Mailing Address - Street 2:411
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2386
Mailing Address - Country:US
Mailing Address - Phone:615-293-4172
Mailing Address - Fax:
Practice Address - Street 1:129 SOUTH LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWERENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464
Practice Address - Country:US
Practice Address - Phone:931-762-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000016894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily