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Individual

DR. MICHELE NICOLE COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
611 E DOUGLAS RD STE 406, MISHAWAKA, IN 46545
(574) 335-6580
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01073777A
IN
207Q00000X
Family Medicine Physician
01073777B
IN
207Q00000X
Family Medicine Physician
036139645
IL
207Q00000X
Family Medicine Physician
11017396A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201170290
IN
01
592050
MEDICARE PTAN GROUP
IL
01
F400330742
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
07/01/2012
Last updated
01/13/2026
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