Provider Demographics
NPI:1528048113
Name:COLLINS, SUE E (NP)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:E
Last Name:COLLINS
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 1:800 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-9010
Mailing Address - Country:US
Mailing Address - Phone:828-682-0200
Mailing Address - Fax:828-682-2023
Practice Address - Street 1:800 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-9010
Practice Address - Country:US
Practice Address - Phone:828-682-0200
Practice Address - Fax:828-682-2023
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC005001124363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2592520Medicare Oscar/Certification
F54628Medicare UPIN