| NPI | 1982087466 |
|---|---|
| Former Name | IVETTE COLLAZO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9194110) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9194110) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2025-03-12 |