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General NPI Number Information
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NPI Number | 1922810217
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Entity Type | Individual
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Provider Name | KELLY LYNN COLLINS RN
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 4802 S. 9TH STREET
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City | KALAMAZOO
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State | MI
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Zip | 49009
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Country | US
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Telephone | 269-360-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 7877 WILLOW CHASE BLVD
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City | HOUSTON
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State | TX
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Zip | 77070-5934
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Country | US
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Telephone | 832-869-4818
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704309065
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License Number State | MI
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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 | 4704309065
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License Number State | MI
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