Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35089693 | OH |
N | 207Q00000X | Family Doctor | MD430401 | PA |
N | 207Q00000X | Family Doctor | MT184315 | PA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD430401 | PA |
NPI | 1417172461 |
---|---|
Provider Name | Ms. Annelise Collier |
First Address | Bethlehem, PA 18015-1000 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 04/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1026464610002 | (05) | PA |