Individual
JASON COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-7000
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
21228
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
21228
SC
Other
Enumeration date
08/10/2017
Last updated
05/23/2021
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