Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 95009008 | CA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | R190493 | MD |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95009008 | CA |
NPI | 1609496801 |
---|---|
Provider Name | Mr. Nicholas Andrew Collins |
First Address | Baltimore, MD 21201-1590 |
Second Address | Baltimore, MD 21201-1590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2020 |
Last Update Date | 10/02/2021 |