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Individual

MRS. JESSICA MICHELLE COLLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
106 HARTFORD RD E, FORT GAINES, GA 39851-3638
(229) 768-2633
(229) 768-2263
Mailing address
PO BOX 489, CUTHBERT, GA 39840-0489
(229) 768-2633
(229) 768-2263

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN162833
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1558518472
AL
05
688551706A
GA
Enumeration date
08/21/2008
Last updated
04/27/2009
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