| Doctor Name: | KELLIE COLLINS |
| NPI Number: | 1013026517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.R.N.P |
| License Number: | ARNP1946582 |
| Business Practice Address: | 4516 Sw Yamada Dr Port St Lucie, FL - 349538518 |
| Business Phone Number: | 7723362161 |
| Business Fax Number: | |
| Mailing Address: | 4516 Sw Yamada Dr, PORT ST LUCIE |
| State: | FL |
| Postal Code: | 349538518 |
| Phone Number: | 7723362161 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP1946582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |