Kathleen M Collins, GNP
Individual provider Active NPI Gerontology Nurse Practitioner · Newark, NY
NPI 1295068427 · NPPES record last updated Dec 23, 2009
Key facts
- NPI
- 1295068427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- F340736-1 (NY)
- Practice address
- 1208 Driving Park Ave
Newark, NY 14513-1057 - Phone
- (315) 359-2640
- NPI assigned
- Sep 4, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F340736-1 | NY | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | F340736-1 | NY | Yes |
Addresses
Primary practice location
1208 Driving Park Ave
Newark, NY 14513-1057
Mailing address
1208 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 359-2640
Other providers in Newark, NY
- Alex William Cobb
- Kent C Coil
- Katharine B Coleman
- Deirdre Colgan
- Donna Joy Collins I
- Nicole A Collins
- Janice Comer
- Complete Foot Care of the Finger Lakes, PLLC
- Lauren Conaty
- Connected Treasures. LCSW, PLLC
All providers in Newark, NY · Gerontology Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.