Individual
MR. GARY L COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
851 LOCUST ST, ROGERSVILLE, TN 37857-2407
(423) 921-7000
(423) 224-3258
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN0000053813
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3050981
BCBS
TN
05
—
3602591
—
TN
Enumeration date
09/14/2005
Last updated
02/29/2008
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