Healthcare Provider Details

I. General information

NPI: 1639553753
Provider Name (Legal Business Name): ALISON ELIZABETH COLLIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 DONNINGTON CT
SIMI VALLEY CA
93065-7015
US

IV. Provider business mailing address

742 DONNINGTON CT
SIMI VALLEY CA
93065-7015
US

V. Phone/Fax

Practice location:
  • Phone: 303-523-7069
  • Fax:
Mailing address:
  • Phone: 303-523-7069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number677429-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF340317-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: