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General NPI Number Information
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NPI Number | 1205422649
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Entity Type | Individual
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Provider Name | DIANE A COLLINS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 622 W 168TH ST PH 5-505
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-6494
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 HURON CIR
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City | KISSIMMEE
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State | FL
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Zip | 34746-3437
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Country | US
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Telephone | 754-207-6565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11009758
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 353246
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License Number State | NY
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