Provider Demographics
NPI:1851281885
Name:COLLAZO, MICHELLE (RN, BSN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:COLLAZO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:AZEVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:3317 DOG LEG DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-7722
Mailing Address - Country:US
Mailing Address - Phone:775-230-2885
Mailing Address - Fax:
Practice Address - Street 1:3317 DOG LEG DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-7722
Practice Address - Country:US
Practice Address - Phone:775-230-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN76322163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse