Provider Demographics
NPI:1538382064
Name:COLLINS, DENISE D (CRNA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:D
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5306
Mailing Address - Country:US
Mailing Address - Phone:856-848-7414
Mailing Address - Fax:215-757-4127
Practice Address - Street 1:246 WHEATSHEAF LN
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1551
Practice Address - Country:US
Practice Address - Phone:215-757-5594
Practice Address - Fax:215-757-4127
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN334526L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered