Provider Demographics
NPI:1861487092
Name:COLLINS, ROBIN A (FNP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:3618 WICKLOW ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3332
Mailing Address - Country:US
Mailing Address - Phone:916-482-2133
Mailing Address - Fax:916-482-2133
Practice Address - Street 1:3840 WATT AVE BLDG E
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2640
Practice Address - Country:US
Practice Address - Phone:916-488-6200
Practice Address - Fax:916-488-6300
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN248950163W00000X
CAFNP9930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEY410ZMedicare PIN