Provider Demographics
NPI:1881566776
Name:COLLINS, LAFLORENCE MERRILLE (CNA)
Entity type:Individual
Prefix:
First Name:LAFLORENCE
Middle Name:MERRILLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:LAFLORENCE
Other - Middle Name:MERRILLE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:333 W BROWN DEER RD UNIT G-603
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2372
Mailing Address - Country:US
Mailing Address - Phone:262-993-9556
Mailing Address - Fax:775-640-6832
Practice Address - Street 1:9011 N 86TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-1805
Practice Address - Country:US
Practice Address - Phone:262-993-9556
Practice Address - Fax:775-640-6832
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148760376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide