Healthcare Provider Details

I. General information

NPI: 1376786806
Provider Name (Legal Business Name): SHIRLEY ANN COLLINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHIRLEY ANN HIPSHIRE RN

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HEDRICK DR
NEWPORT TN
37821-2902
US

IV. Provider business mailing address

DEPT 888182
KNOXVILLE TN
37995-0001
US

V. Phone/Fax

Practice location:
  • Phone: 423-623-5301
  • Fax: 423-625-0808
Mailing address:
  • Phone: 800-355-3565
  • Fax: 423-714-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN166580
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: