Individual
FAYE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 W 4TH ST, HATTIESBURG, MS 39401-4753
(601) 310-3287
Mailing address
3302 BROOKWOOD DR, HATTIESBURG, MS 39401-7207
(601) 310-3287
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
04404067
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04404067
—
MS
Enumeration date
12/13/2017
Last updated
12/13/2017
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