Individual
MARY W. COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1926 23RD AVE, MERIDIAN, MS 39301-3107
(601) 485-1131
(601) 485-1336
Mailing address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 485-1131
(601) 485-1336
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R851820
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00127115
—
MS
01
—
P00339767
RAILROAD MEDICARE
GA
Enumeration date
08/12/2006
Last updated
11/09/2012
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