Provider Demographics
NPI:1336897503
Name:COLLARD, MEREDITH LYNNE (DNP, RN, BSN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LYNNE
Last Name:COLLARD
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Gender:F
Credentials:DNP, RN, BSN
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Mailing Address - Street 1:4928 PINE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1613
Mailing Address - Country:US
Mailing Address - Phone:713-859-4677
Mailing Address - Fax:
Practice Address - Street 1:12222 MERIT DR STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3294
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1064613163WC0200X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine