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Individual

MARY LETA COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
120 WALNUT COMMONS LN, SUITE C, COOKEVILLE, TN 38501-6035
(931) 526-5777
(931) 526-9749
Mailing address
501 GREAT CIRCLE RD, STE. 200, NASHVILLE, TN 37228
(931) 526-5777
(931) 526-5207

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN000005798
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3343249
TN
Enumeration date
10/03/2006
Last updated
08/14/2015
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