Healthcare Provider Details

I. General information

NPI: 1861473761
Provider Name (Legal Business Name): MAUREEN A COLLINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3745 33RD ST N SUITE A
ST PETERSBURG FL
33713-1556
US

IV. Provider business mailing address

7527 ULMERTON RD SUITES L & M
LARGO FL
33771-4548
US

V. Phone/Fax

Practice location:
  • Phone: 727-231-0154
  • Fax: 727-231-0158
Mailing address:
  • Phone: 727-585-4833
  • Fax: 727-588-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP721352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: