Healthcare Provider Details

I. General information

NPI: 1215248315
Provider Name (Legal Business Name): LATOYA NICOLE COLLINS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 MCDANIEL RD APT 11104
DULUTH GA
30096-8654
US

IV. Provider business mailing address

3355 MCDANIEL RD APT 11104
DULUTH GA
30096-8654
US

V. Phone/Fax

Practice location:
  • Phone: 513-827-4732
  • Fax:
Mailing address:
  • Phone: 513-827-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN333139
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: