Individual
SAMANTHA ALEXANDRIA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP,FNP-C
Contact information
Practice address
2 COTTONWOOD RD, GLEN CARBON, IL 62034-2782
(314) 687-2733
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1530
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209014613
IL
363LF0000X
Family Nurse Practitioner
209014613
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215481924
—
WI
Enumeration date
08/10/2016
Last updated
06/10/2021
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