Provider Demographics
NPI:1265621221
Name:COLLINS, PAMELA L (RN)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-2152
Mailing Address - Country:US
Mailing Address - Phone:740-490-7162
Mailing Address - Fax:
Practice Address - Street 1:1095 WESLEY DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-2152
Practice Address - Country:US
Practice Address - Phone:740-490-7162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 299622163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse