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General NPI Number Information
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NPI Number | 1720632748
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Entity Type | Individual
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Provider Name | TONI LAVAUGHN COLLINS FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2019
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 5855 N HIGHWAY 11 SE
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City | ELIZABETH
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State | IN
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Zip | 47117-9039
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Country | US
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Telephone | 812-969-2959
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 38
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City | CORYDON
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State | IN
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Zip | 47112-0038
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Country | US
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Telephone | 812-738-4251
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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 | 3013749
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3013749
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28173414A
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License Number State | IN
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