Provider Demographics
NPI:1285158428
Name:COLLIER, CHANTEL (NP)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FRIEND
Mailing Address - State:NE
Mailing Address - Zip Code:68359-1133
Mailing Address - Country:US
Mailing Address - Phone:402-947-2541
Mailing Address - Fax:
Practice Address - Street 1:905 2ND ST
Practice Address - Street 2:
Practice Address - City:FRIEND
Practice Address - State:NE
Practice Address - Zip Code:68359-1133
Practice Address - Country:US
Practice Address - Phone:402-947-2541
Practice Address - Fax:402-947-2951
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112291363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily