Healthcare Provider Details

I. General information

NPI: 1215766753
Provider Name (Legal Business Name): HEATHER COLLINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 S JEFFERSON ST
NAPA CA
94559-4515
US

IV. Provider business mailing address

414 S JEFFERSON ST
NAPA CA
94559-4515
US

V. Phone/Fax

Practice location:
  • Phone: 707-531-6190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95029777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: