Healthcare Provider Details

I. General information

NPI: 1013496660
Provider Name (Legal Business Name): YVONNE ANNETTE COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST FL 3
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

415 FRANKLIN AVE
SALISBURY MD
21804-5525
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-2208
  • Fax:
Mailing address:
  • Phone: 443-523-8311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN161561
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: