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Individual

JACLYN C. COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1155 MAIN ST, YOUNG HARRIS, GA 30582
(706) 439-6873
(706) 439-6874
Mailing address
35 HOSPITAL RD, BLAIRSVILLE, GA 30512-3139
(706) 745-2111

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN208019
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003161419A
GA
05
1124424536
NC
Enumeration date
11/12/2014
Last updated
01/16/2019
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