Provider Demographics
NPI:1386601219
Name:COLLINS, LYNDA (CRNA)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-0495
Mailing Address - Country:US
Mailing Address - Phone:302-945-9730
Mailing Address - Fax:
Practice Address - Street 1:32711 LONG NECK RD
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-6678
Practice Address - Country:US
Practice Address - Phone:302-945-9730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL60A00128367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DES38187Medicare UPIN
DE870207Medicare ID - Type Unspecified