Provider Demographics
NPI:1144629767
Name:COLLINS, RACHEL KATHLEEN (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:KATHLEEN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:KATHLEEN
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:1655 WAKE DR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4746
Mailing Address - Country:US
Mailing Address - Phone:195-564-7799
Mailing Address - Fax:919-556-5277
Practice Address - Street 1:1655 WAKE DR UNIT 101
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4746
Practice Address - Country:US
Practice Address - Phone:195-564-7799
Practice Address - Fax:919-556-5277
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018416363LP2300X
MA2292551163W00000X
CT8173363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110100777AOtherMASSHEALTH