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Individual

STEPHANIE COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1234 MADISON HIGH DRIVE, TALLULAH, LA 71282-4204
(318) 574-5371
Mailing address
110 BELLE LN, TALLULAH, LA 71282-5502

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04249
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1165221
LA
Enumeration date
08/31/2006
Last updated
04/23/2012
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