Provider Demographics
NPI:1700286101
Name:COLLINGS, ANNA MICHELLE (AP, DOM)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MICHELLE
Last Name:COLLINGS
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 ISLAND BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5063
Mailing Address - Country:US
Mailing Address - Phone:321-289-1560
Mailing Address - Fax:
Practice Address - Street 1:1375 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4470
Practice Address - Country:US
Practice Address - Phone:321-289-1560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1509171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist