Provider Demographics
NPI:1770912362
Name:COLLUM, ASHLEY (ARNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:COLLUM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18241 THATCHAM CT
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8160
Mailing Address - Country:US
Mailing Address - Phone:813-394-7284
Mailing Address - Fax:
Practice Address - Street 1:2322 LAND O LAKES BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-2919
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9320144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily