Provider Demographics
NPI:1548553423
Name:COLLIER, KATHERINE ELIZABETH (ANP)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:COLLIER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SMOKY CROSSING WAY
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5074
Mailing Address - Country:US
Mailing Address - Phone:203-668-0758
Mailing Address - Fax:
Practice Address - Street 1:250 SMOKY CROSSING WAY
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-5074
Practice Address - Country:US
Practice Address - Phone:203-668-0758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15380363LA2200X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)