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General NPI Number Information
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NPI Number | 1336798057
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Entity Type | Individual
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Provider Name | DALE K COLLIER NP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 1401 JOHNSTON WILLIS DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4730
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Country | US
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Telephone | 804-483-6240
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Fax | 804-483-6241
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Provider Business Mailing Address
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Address Line | 1401 JOHNSTON WILLIS DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4789
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Country | US
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Telephone | 804-483-6240
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Fax | 804-483-6241
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024178139
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License Number State | VA
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