Provider Demographics
NPI:1174876056
Name:COLLINS, TARONICA SHAMEL (CERTIFIED NURSE ASSI)
Entity type:Individual
Prefix:MISS
First Name:TARONICA
Middle Name:SHAMEL
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CERTIFIED NURSE ASSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 TEAGARDEN COURT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-8684
Mailing Address - Country:US
Mailing Address - Phone:214-403-1477
Mailing Address - Fax:
Practice Address - Street 1:2015 TEAGARDEN COURT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-8684
Practice Address - Country:US
Practice Address - Phone:214-403-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA08876222376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide