Provider Demographics
NPI:1619765930
Name:COLLINS, ASHLY (NP)
Entity type:Individual
Prefix:MRS
First Name:ASHLY
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24123 GREENFIELD RD STE 211
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3140
Mailing Address - Country:US
Mailing Address - Phone:248-701-0854
Mailing Address - Fax:
Practice Address - Street 1:24123 GREENFIELD RD STE 211
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3140
Practice Address - Country:US
Practice Address - Phone:248-701-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care