Provider Demographics
NPI:1083398168
Name:COLLINS, SHEREKA D (APRN FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHEREKA
Middle Name:D
Last Name:COLLINS
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:MISS
Other - First Name:SHEREKA
Other - Middle Name:D
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3981
Mailing Address - Country:US
Mailing Address - Phone:217-366-8130
Mailing Address - Fax:217-366-7488
Practice Address - Street 1:1801 W WINDSOR RD
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-6217
Practice Address - Country:US
Practice Address - Phone:217-366-8130
Practice Address - Fax:217-366-7488
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.027606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily