Healthcare Provider Details

I. General information

NPI: 1619933975
Provider Name (Legal Business Name): PATRICIA DALE COLLINS-YOUNG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA DALE COLLINS

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 OCILLA RD
DOUGLAS GA
31533-2207
US

IV. Provider business mailing address

210 CAMELLIA AVE
DOUGLAS GA
31533-3276
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-5703
  • Fax:
Mailing address:
  • Phone: 912-381-7595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN-CRNA050943
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: