1497779243 NPI number — MRS. EMILY CURRY COLLINS APRN-BC

Table of content: MRS. EMILY CURRY COLLINS APRN-BC (NPI 1497779243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497779243 NPI number — MRS. EMILY CURRY COLLINS APRN-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLLINS
Provider First Name:
EMILY
Provider Middle Name:
CURRY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLIFFORD
Provider Other First Name:
EMILY
Provider Other Middle Name:
CURRY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497779243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2202 N WEST SHORE BLVD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33607-5749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-862-1553
Provider Business Mailing Address Fax Number:
480-718-7643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1949 NORTHGATE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARASOTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34234-2143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-373-7844
Provider Business Practice Location Address Fax Number:
941-373-7856
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP9299772 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003713900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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