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NPI Code Detail

MEDICARE: LORIE TYSON COLLIER ANP

MEDICARE: LORIE TYSON COLLIER ANP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner5006060NC

General Provider Information

NPI Number : 1578803219
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORIE TYSON COLLIER ANP
Provider Business Mailing Address
First Line : 1380 COWELL FARM RD
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3431
Country : US
Telephone Number : 252-946-2101
Fax Number : 252-946-9896
Provider Business Practice Location Address
First Line : 1380 COWELL FARM RD
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3431
Country : US
Telephone Number : 252-946-2101
Fax Number : 252-946-9896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2013
Last Update Date : 05/12/2026

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