Provider Demographics
NPI:1972024040
Name:COLLINS, CHRISTINE MARY (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BYEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2026
Mailing Address - Country:US
Mailing Address - Phone:716-574-1214
Mailing Address - Fax:
Practice Address - Street 1:393 NORTH ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-9652
Practice Address - Country:US
Practice Address - Phone:716-592-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY488890-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool