Provider Demographics
NPI:1063597466
Name:COLLINS, ELINOR M (CNS)
Entity type:Individual
Prefix:
First Name:ELINOR
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MAUDE STREET
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908
Mailing Address - Country:US
Mailing Address - Phone:401-456-2595
Mailing Address - Fax:
Practice Address - Street 1:50 MAUDE STREET
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-456-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN16222163WP0809X
RIPPNS00014364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1255367942OtherUMG NPI NUMBER
RI709003967OtherGROUPS PROVIDER NUMBER
RI709003967OtherGROUPS PROVIDER NUMBER