=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851050058
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVIE MARIE COLLINS APRN-BC CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2021
-----------------------------------------------------
Last Update Date | 09/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3798 JANES RD STE 6
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521-4745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-825-4958
-----------------------------------------------------
Fax | 707-825-4978
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3798 JANES RD STE 6
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521-4745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-825-4958
-----------------------------------------------------
Fax | 707-825-4978
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 95034372
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------