Provider Demographics
NPI:1851844120
Name:COLLIER, KATHRYN (LPN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13160-0177
Mailing Address - Country:US
Mailing Address - Phone:315-283-4428
Mailing Address - Fax:
Practice Address - Street 1:4 HOMER ST
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13160-2447
Practice Address - Country:US
Practice Address - Phone:315-283-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275132164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse