Provider Demographics
NPI:1437977717
Name:COLLIER, MARCUS ANDRE
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:ANDRE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9365 HICKORY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8977
Mailing Address - Country:US
Mailing Address - Phone:810-210-0743
Mailing Address - Fax:
Practice Address - Street 1:9365 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-8977
Practice Address - Country:US
Practice Address - Phone:810-210-0743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist