Provider Demographics
NPI:1902953292
Name:COLLATOS, NICOLE C (RN,FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:C
Last Name:COLLATOS
Suffix:
Gender:F
Credentials:RN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-5330
Mailing Address - Country:US
Mailing Address - Phone:254-732-0052
Mailing Address - Fax:254-732-0150
Practice Address - Street 1:635 N ROBINSON DR
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:TX
Practice Address - Zip Code:76706-5330
Practice Address - Country:US
Practice Address - Phone:254-732-0052
Practice Address - Fax:254-732-0150
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily