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Individual

DIANA LEE COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
148 SAULS ST, LAKE CITY, SC 29560-2677
(843) 374-3621
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
18807
SC
363LF0000X
Family Nurse Practitioner
Primary
18807
SC

Other

Enumeration date
02/26/2014
Last updated
10/08/2020
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