Provider Demographics
NPI:1730215922
Name:COLLINS, MICHELLE ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1077
Mailing Address - Country:US
Mailing Address - Phone:740-774-2241
Mailing Address - Fax:740-774-2241
Practice Address - Street 1:281 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1077
Practice Address - Country:US
Practice Address - Phone:740-774-2241
Practice Address - Fax:740-774-2241
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH326884163W00000X
OH106717164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2494117Medicaid