Healthcare Provider Details

I. General information

NPI: 1275957185
Provider Name (Legal Business Name): TONYA RENEE COLLINS APRN,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TONYA ACKLES

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34290 FORD RD
WESTLAND MI
48185-3051
US

IV. Provider business mailing address

34290 FORD RD
WESTLAND MI
48185-3051
US

V. Phone/Fax

Practice location:
  • Phone: 313-516-3142
  • Fax:
Mailing address:
  • Phone: 313-516-3142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704288991
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704288991
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: