Healthcare Provider Details

I. General information

NPI: 1790747376
Provider Name (Legal Business Name): JUDITH ANN COLLINS MSN, RN, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E STAR CT
MONTROSE CO
81401
US

IV. Provider business mailing address

2233 E MAIN ST
MONTROSE CO
81401-3831
US

V. Phone/Fax

Practice location:
  • Phone: 970-252-1020
  • Fax: 970-252-1041
Mailing address:
  • Phone: 970-765-0818
  • Fax: 970-497-8410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number170211
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704106343
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0004666-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: