Individual
PEGGY S COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
62 MAUDE RD, INEZ, KY 41224-9124
(731) 394-1145
Mailing address
36 PEMBERTON CV, JACKSON, TN 38305-5514
(731) 394-1145
(844) 374-0233
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
965
SC
363LF0000X
Family Nurse Practitioner
Primary
3015599
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0217
—
SC
Enumeration date
04/14/2006
Last updated
05/19/2021
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