Provider Demographics
NPI:1700591633
Name:COLLINS, SHELLEY RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:RENEE
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 1:11491 SW 70TH PL
Mailing Address - Street 2:
Mailing Address - City:CEDAR KEY
Mailing Address - State:FL
Mailing Address - Zip Code:32625-2502
Mailing Address - Country:US
Mailing Address - Phone:352-325-0538
Mailing Address - Fax:
Practice Address - Street 1:2708 SW ARCHER RD FL 32608
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1316
Practice Address - Country:US
Practice Address - Phone:352-554-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9509768163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical