Healthcare Provider Details

I. General information

NPI: 1093110967
Provider Name (Legal Business Name): EMILY COLLIER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 11/04/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 FORTUNE BOULEVARD
MILFORD MA
01757
US

IV. Provider business mailing address

321 FORTUNE BOULEVARD
MILFORD MA
01757
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-5996
  • Fax: 508-634-7857
Mailing address:
  • Phone: 508-478-5996
  • Fax: 508-634-7857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNPP37872
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: