Basic Information
| Provider Information | |||||||||
| NPI: | 1942811419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOLLEKTSIONOVA | ||||||||
| FirstName: | NATALYA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11161 STATE ROAD 70 E STE 110-513 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD RANCH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342029407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8646014060 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2020 59TH ST W | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342094604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417926611 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2020 | ||||||||
| LastUpdateDate: | 09/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | RN9537037 | FL | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 367500000X | APRN11009241 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.