Provider Demographics
NPI:1457825713
Name:COLLINS, ELIZABETH (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DENDRON RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2527
Mailing Address - Country:US
Mailing Address - Phone:401-862-9532
Mailing Address - Fax:
Practice Address - Street 1:4512 POST RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-4124
Practice Address - Country:US
Practice Address - Phone:401-884-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIL15148163WL0100X
RIRN27873163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant