Provider Demographics
NPI:1184055675
Name:COLLETT, CHRISTOPHER (EMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:COLLETT
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 HOSPITAL LOOP ROAD
Mailing Address - Street 2:
Mailing Address - City:OWYHEE
Mailing Address - State:NV
Mailing Address - Zip Code:89832
Mailing Address - Country:US
Mailing Address - Phone:775-757-2415
Mailing Address - Fax:
Practice Address - Street 1:1623 HOSPITAL LOOP ROAD
Practice Address - Street 2:
Practice Address - City:OWYHEE
Practice Address - State:NV
Practice Address - Zip Code:89832
Practice Address - Country:US
Practice Address - Phone:775-757-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDI0721676146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate