Individual
ANN VIRAE COLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
750 N BROADWAY, PERU, IN 46970-1027
(260) 266-8840
(260) 266-8849
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102201775
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
0102201775
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
02002938A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10022013
SENTARA/OPTIMA
VA
05
—
1518096767
—
VA
05
—
200907500
—
IN
01
—
304619
ANTHEM
VA
01
—
3168998
UHC/MAMSI
VA
05
—
5906049
—
NC
Enumeration date
03/05/2007
Last updated
09/02/2025
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