Provider Demographics
NPI:1104587617
Name:COLLINS, AMY NICOLE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 WATERMELON RD STE 111
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5250
Mailing Address - Country:US
Mailing Address - Phone:205-333-8554
Mailing Address - Fax:205-752-7696
Practice Address - Street 1:4280 WATERMELON RD STE 111
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5250
Practice Address - Country:US
Practice Address - Phone:205-333-8554
Practice Address - Fax:205-752-7696
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily