Provider Demographics
NPI:1932922515
Name:COLLIER, KELLEY LEANN (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:LEANN
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:808 HUNTER AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-2253
Mailing Address - Country:US
Mailing Address - Phone:573-475-9111
Mailing Address - Fax:573-475-7443
Practice Address - Street 1:808 HUNTER AVE STE 4
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-2253
Practice Address - Country:US
Practice Address - Phone:573-475-9111
Practice Address - Fax:573-475-7443
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024043511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily