Provider Demographics
NPI:1598527301
Name:COLLIER, JASMINE N
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:N
Last Name:COLLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6390 WINDING CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9266
Mailing Address - Country:US
Mailing Address - Phone:585-690-2203
Mailing Address - Fax:
Practice Address - Street 1:6390 WINDING CREEK WAY
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9266
Practice Address - Country:US
Practice Address - Phone:585-690-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342998164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse