Provider Demographics
NPI:1447003694
Name:COLLINS, MARLA ELIZABETH (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:ELIZABETH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 N TESUQUE RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3602
Mailing Address - Country:US
Mailing Address - Phone:510-853-5087
Mailing Address - Fax:
Practice Address - Street 1:2095 N TESUQUE RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3602
Practice Address - Country:US
Practice Address - Phone:510-853-5087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN29495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse