Healthcare Provider Details

I. General information

NPI: 1568960250
Provider Name (Legal Business Name): CATHERINE COLLINS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2018
Last Update Date: 11/27/2023
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W. 800 N. SUITE 220
OREM UT
84057
US

IV. Provider business mailing address

1055 N 500 W ATTN. CREDENTIALING
PROVO UT
84604
US

V. Phone/Fax

Practice location:
  • Phone: 801-354-8205
  • Fax: 801-354-8206
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7879746-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7879746-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: