Provider Demographics
NPI:1841174331
Name:COLLINS, PAIGE LANIA (NP)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:LANIA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:LANIA
Other - Last Name:TACKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5647
Mailing Address - Country:US
Mailing Address - Phone:580-272-7261
Mailing Address - Fax:
Practice Address - Street 1:6611 E CENTRAL AVE STE E
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1937
Practice Address - Country:US
Practice Address - Phone:316-858-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84625-061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily