Provider Demographics
NPI:1144328097
Name:COLLETT, PAMELA L (ARNP, BC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:COLLETT
Suffix:
Gender:F
Credentials:ARNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9180 GALLERIA COURT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-841-2010
Mailing Address - Fax:239-841-2010
Practice Address - Street 1:9180 GALLERIA COURT
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-841-2010
Practice Address - Fax:239-841-2010
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1885122163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY3811ZMedicare ID - Type Unspecified
FLS90030Medicare UPIN