Theresa Lynn Collins, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11027347 Issued in FL

Practice address

2268 Gardenmoss Dr
Green Cove Springs, FL 32043-6208

Phone

(904) 349-1789

NPI assigned

Aug 15, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1801679808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2268 GARDENMOSS DR",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320436208",
            "telephone_number": "904-349-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 GARDENMOSS DR",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320436208",
            "telephone_number": "904-349-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay County District Schools
• Clay County District Schools
• Clay County District Schools
• Clay Pharmacy Inc
• Kristen Cleary, LCSW
• Kelly Colston
• Kassandra Concepcion
• Emma Rose Connors
• Sherry Craig
• Creekside Physical Therapy LLC

• Family Nurse Practitioner in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.