MEDICARE: COY COLLINS NP

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
1	363LF0000X	Family Nurse Practitioner	218603	AZ
2	363LA2100X	Acute Care Nurse Practitioner	218603	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	218603	AZ

General Provider Information

NPI Number	:	1861956054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COY COLLINS NP

Provider Business Mailing Address
First Line	:	4764 E SUNRISE DR # 787
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4764 E SUNRISE DR # 787
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4535
Country	:	US
Telephone Number	:	520-775-2655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/28/2026

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Directions to “ COY COLLINS NP” Practice Location

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