Individual
KENNETH VICTOR COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
Mailing address
601 OMEGA DR STE 208, ARLINGTON, TX 76014-2075
(817) 465-5881
(817) 465-6336
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP142526
TX
363LA2100X
Acute Care Nurse Practitioner
AP142526
TX
Other
Enumeration date
08/05/2019
Last updated
10/13/2021
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