Provider Demographics
NPI:1386117448
Name:COLLIER, BERNADINE D (RN)
Entity type:Individual
Prefix:
First Name:BERNADINE
Middle Name:D
Last Name:COLLIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LANCE CT
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39817-1724
Mailing Address - Country:US
Mailing Address - Phone:229-254-5916
Mailing Address - Fax:
Practice Address - Street 1:107 LANCE CT
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39817-1724
Practice Address - Country:US
Practice Address - Phone:229-254-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222884163W00000X
FLRN9346398163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse